冯薇

[摘要] 目的 研究超声积分法结合弹性成像（UE）应变率比值法，半定量鉴别乳腺实性肿块良、恶性的应用价值。方法 选取2014年3月～2015年2月均经手术病理证实的46例患者，共52个乳腺实性肿块，首先进行彩色多普勒常规超声检查，然后应用超声积分法与UE比值法评判其良、恶性，采用受试者工作特性曲线（ROC曲线）评价积分法及UE比值法的价值及相关性。 结果 乳腺实性肿块良性与恶性的超声总积分及UE比值均有差异，以病理结果为金标准，恶性肿块的总积分及UE比值均高于良性肿块，但两种诊断方法均有不足，在诊断中可以互补。根据ROC曲线，总积分13.5为临界值，曲线最接近左上角，其敏感性、特异性分别为83.8%、86.9%；而UE比值3.05为临界值，其敏感性、特异性分别为83.5%、89.6%。 结论 超声积分法及UE比值法均能半定量评价乳腺实性肿块的良、恶性，二者相结合，取长补短，可以明显提高超声诊断的准确率和可靠性。

[关键词] 超声积分；弹性成像；应变率；乳腺肿块

[中图分类号] R445.1 [文献标识码] A [文章编号] 1673-9701（2015）34-0014-04

Study on ultrasonography score combined with ultrasonic elastography strain rate ratio in the identification of benign and malignant breast solid mass

FENG Wei

Department of Ultrasonography， Hebi People's Hospital of Shancheng Branch in He'nan Province， Hebi 458000， China

[Abstract] Objective To explore the application value of ultrasonography score combined with ultrasonic elastography （UE） strain rate ratio applied in the semi-quantitative identification of benign and malignant breast solid mass. Methods 46 patients diagnosed by surgery and pathological examination from March 2014 to February 2015 were selected. There were 52 breast solid tumors in total. The regular color Doppler ultrasonography was firstly performed， and ultrasonography score and UE ratio were applied to judge whether they were benign or malignant. ROC curve was applied to evaluate the value and correlation between ultrasonography score and UE ratio. Results The total ultrasonography score and UE ratio of benign and malignant breast solid mass were both different. With the golden standard of pathological results， the total score and UE ratio of malignant mass were both higher than those of benign mass， but the two kinds of diagnostic methods were both insufficient， which could be supplemented with each other in diagnosis. According to the ROC curve， the total ultrasonography score of 13.5 was the cutoff value， and the curve was most approaching to the left corner. Its sensitivity and specificity were 83.8% and 86.9% respectively； the UE ratio of 3.05 was the cutoff value， and its sensitivity and specificity were 83.5% and 89.6% respectively. Conclusion Ultrasonography score combined with UE ratio are both able to semi-quantitatively evaluate the benign and malignant breast solid mass. The combination of the two methods is able to supplement with each other and significantly improve the accuracy and reliability of ultrasonography.

[Key words] Ultrasonography score； Ultrasonic elastography（UE）； Strain rate； Breast mass

近年来，乳腺癌已成为我国妇女最常见的恶性肿瘤。乳腺癌的早诊断、早发现、早治疗至关重要[1]。如何早期、准确的诊断乳腺癌一直是超声医师的关注焦点。众所周知，高频彩超为乳腺癌首选检查方法[2]，因其直观、便捷、无创、可重复性好。但在实践工作中，因超声医师的技术水平不一，超声图像的描述难免会受到一些主观因素的影响，而对乳腺实性肿块良、恶性的定量分析就显得非常必要。本文旨在将超声积分法结合UE比值法半定量分析乳腺实性肿块的良、恶性，并结合病理对照，从而评价其在鉴别诊断中的价值，现报道如下。……