中文摘要：

目的：比较BI—RADS—US诊断标准与弹性成像应变率比值对乳腺良恶性肿块的诊断价值。方法：对经手术病理证实的140例患者共159个肿块进行常规超声检查并按照BI—RADS—US标准诊断分级，再进行超声弹性成像检查，测定肿块与周围组织的弹性应变率比值，以弹性应变率比值≥3．08为界点判断肿块良恶性，以病理诊断结果为金标准，对比分析两种方法诊断乳腺肿块良恶性的准确度；构建受试者工作特征（ROC）曲线，比较两种方法对乳腺肿块的诊断效率。结果：良性78例共88个肿块．恶性62例共71个肿块，BI—RADS—US诊断乳腺良恶性病变的敏感性为91．55％（65／71），特异性为73．86％（65／88），准确性为81．76％（130／159）；弹性应变率比值诊断乳腺良恶性病变敏感性为94.37％（67／71），特异性为87．50％（77／88），准确性为90．56％（144／159）。构建ROC曲线后，两种方法的曲线下面积（AUC）分别为：BI—RADS—US诊断0．851，95％可信区间0．791±0．911；应变率比值诊断0．887，95％可信区间0．825～0．950。两种方法准确性的配对卡方McNemar检验结果P〈O．05，差异具有统计学意义。结论：超声弹性成像应变率比值测定鉴别乳腺良恶性肿块较B1-RADS—US诊断分级准确性高，对于BI—RADS—USⅣ级肿块更具诊断价值。

英文摘要：

Objective： To compare the diagnostic value of BI-RADS and ultrasonic elastography in the differentiation of breast lesions. Methods： 140 patients with 159 lesions were included in the study. The lesions were scored with BI-RADS and ultrasound elastography （UE） respectively. The pathologic diagnosis was the gold standard. The diagnostic performance of the 2 methods was evaluated with receiver operating charaeteristie（ROC） curve. Result： The areas under the eurve（AUC） of the 2 methods were BI-RADS 0.851, UE 0.887. After ROC comparing, the diagnostic performance of UE was better than that of BI-RADS （P〈0.05）. The specificity and accuracy of UE were better than those of BI-RADS （P〈0.05）. Conclusions： The UE could improve the differentiation of breast lesions. The grade of IV in BI-RADS should be paid more attention.