目的探讨常规超声结合超声弹性成像(ultrasonic elastography,UE)对乳腺癌的诊断价值,提高超声对乳腺癌的诊断水平。方法应用常规超声结合UE对629例702个乳腺肿块进行检查,借鉴美国放射学会的乳腺影像报告和数据系统对常规超声检查结果进行规范评分,然后结合UE对以上结果进行校准。结果 (1)常规超声检查恶性肿块与良性肿块的各项指标(形态不规则、边缘呈分叶或毛刺征、微钙化、肿块后方回声衰减、肿块内血流达Ⅱ~Ⅲ级、阻力指数≥0.70)间比较差异均有统计学意义(P〈0.05)。(2)常规超声结合UE诊断乳腺癌的ROC曲线下面积为0.928,明显优于常规超声与UE单独应用时(P〈0.001)。结论常规超声与UE联合应用对乳腺良恶性肿块的鉴别具有较高的临床应用价值。
Objective To evaluate the diagnostic application of conventional ultrasonography (US) combined with ultrasonic elastography (UE) for breast cancer. Methods The prospective study of 629 cases with 702 masses was carried out by conventional US combined with UE. The conventional US results were rated according to Breast Imaging Reporting and Data System (BI- RADS) recommended by American college of radiology (ACR) and further adjusted according to UE finding. Results There were significant differences in ultrasonic characteristics (irregular shape, spiculated or microlobulated margin, macrocalcifications, decreased posterior echoes and blood flow rating II - III in lesion, and RI≥0. 70) between malignant lesions and benign lesions. The area under ROC curve of conventional US combined with UE was 0.928, which was higher than conventional US and UE alone (P 〈 0. 001 ). Conclusion Conventional US combined with UE has high clinical value in differentiating benign and malignant masses.