马怀霞　李娜　周红喆

【摘要】 目的 探讨超聲弹性成像技术对乳腺结节良恶性的诊断价值。方法 选取2017年6月至2018年5月期间收治的84例乳腺结节患者作为研究对象，所有患者均行常规超声及超声弹性成像检查，将穿刺活检或手术病理结果作为诊断“金标准”，评价常规超声与超声弹性成像技术对乳腺结节良恶性的诊断价值。结果 84例乳腺结节患者共包含107个结节，病理结果显示良性结节占57.94%，恶性结节占4206%;超声弹性成像技术对乳腺结节良恶性的诊断准确度（93.46%）、灵敏度（91.11%）、特异度（9516%）、阳性预测值（93.18%）及阴性预测值（93.65%）均较常规超声对乳腺结节良恶性的诊断准确度（73.83%）、灵敏度（60.00%）、特异度（83.87%）、阳性预测值（72.97%）及阴性预测值（74.29%）高，差异有统计学意义（P<0.05）。结论 超声弹性成像技术在乳腺结节良恶性诊断中具有较高价值，可有效提升诊断准确度、灵敏度及特异度，进而弥补常规超声诊断的不足。

【关键词】 超声弹性成像技术;乳腺结节;结节性质;常规超声

中图分类号：R655.8;R445.1   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2019.06.012

【Abstract】 Objective To investigate the value of ultrasonic elastography in the diagnosis of benign and malignant breast nodules.Methods 84 patients with breast nodules admitted to hospital from June 2017 to May 2018 were selected as research objects.All patients were examined by conventional ultrasound and ultrasonic elastography.Needle biopsy or surgical pathology results were used as “golden standard” for the diagnosis of breast nodules.And the value of conventional ultrasound and ultrasonic elastography in the diagnosis of benign or malignant breast nodules was evaluated.Results Patients with breast nodules contained 107 nodules，the pathological results showed that benign nodules accounted for 57.94%，and malignant nodules accounted for 42.06%;The diagnostic accuracy，sensitivity，specificity，positive predictive value and negative predictive value of ultrasonic elastography（93.46%，91.11%，95.16%，93.18%，93.65%） in the diagnosis of benign and malignant breast nodules were higher than those of conventional ultrasound（73.83%，60.00%，83.87%，72.97%，74.29%），difference was statistically significant（P<0.05）.Conclusion Ultrasonic elastography has high value in the diagnosis of benign and malignant breast nodules.It can effectively improve the accuracy，sensitivity and specificity of diagnosis，and then make up for the shortcomings of diagnosis of conventional ultrasound.

【Key words】 ultrasonic elastography;breast nodule;nodular nature;conventional ultrasound

乳腺疾病是女性常见疾病，以乳腺结节较为多发，其中良性结节主要包括乳腺增生、纤维腺瘤等，恶性结节以乳腺癌为主，由于该疾病具有较高隐匿性，且病理类型复杂，良恶性病变之间的生物学特性也存在一定差异，治疗方案的制定及对预后的影响也各不相同[1～2]。因此，如何对乳腺结节作出准确鉴别十分关键。目前，临床上对于乳腺结节的鉴别诊断多以超声为主，常规超声虽可对乳腺结节准确定位及定量，但对于定性的诊断准确度及特异度仍处于较低水平[3]。超声弹性成像技术是一种功能性超声成像，可有效判断病变性质及病灶软硬度[4]。基于此，本研究主要探讨超声弹性成像技术对乳腺结节良恶性的诊断价值，现报告如下。……