目的 研究超声弹性成像技术联合常规超声诊断乳腺肿瘤的准确性,分析易误诊病例的影像学特征.方法 回顾性分析301例乳腺肿物患者的临床病历资料,共322个病灶,所有患者均分别用常规超声和超声弹性成像技术进行检查,判断病灶的良恶性倾向,再经病理检查确认、随访.计算不同检查方法的灵敏度、特异度、诊断效率、阳性预测值、阴性预测值及漏诊率,以1-特异度为横轴,灵敏度为纵轴绘制ROC曲线.结果 病理检查良性病灶245个,恶性病灶77个;弹性成像技术联合常规超声诊断的特异度、诊断效率、阳性预测值、阴性预测值分别为93.47%、93.79%、82.02%、98.28%,均较常规超声、超声弹性成像技术单独诊断高.常规超声联合弹性成像技术诊断的灵敏度为94.81%,低于常规超声的96.10%.ROC曲线下面积,常规超声为0.814,VTI弹性成像技术为0.796,两者联合诊断为0.941.结论 超声弹性成像技术联合常规超声诊断乳腺癌的准确度较高,具有良好的应用价值,但临床普及前,诊断标准、规范和相关技术手段仍需完善.%Objective To investigate the diagnostic efficiency of ultrasound elastography combined with convention-al ultrasonography for breast neoplasm, and analyze the imaging characteristic of misdiagnosed cases. Methods 301 pa-tient with 322 lesions were retrospectively analyzed, all were examined by conventional ultrasound and ultrasound elas-tography to evaluate the lesions followed by pathological confirmation and follow up. The sensitivity, specificity, diagnos-tic efficiency, positive predictive value and negative predictive value of each method were calculated, and the ROC were plotted. Results The results of pathological examination showed 245 benign lesions and 77 malignant lesions. Com-bined examination of ultrasound elastography and conventional ultrasound had the specificity, diagnostic efficiency, posi-tive predictive value and negative predictive value as 93.47%, 93.79%, 82.02% and 98.28%, which were significantly higher than each test alone. The sensitivity of combined diagnosis was 94.81%, lower than that of conventional ultra-sound at 96.10%. As for AUC, it was 0.814 for conventional ultrasound, 0.796 for ultrasound elastography and 0.941 for combined diagnosis. Conclusion There was a fine accuracy for ultrasound elastography combined with conventional ul-trasound in detecting breast neoplasms, which is clinically applicable. However, the diagnostic standard, principle and re-lated techniques should be further established before general clinical application.
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