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目的为提高临床对乳腺肿块良恶性的鉴别率,分析剪切波超声弹性成像(SWE)在诊疗中的应用价值。方法通过随机数字表方法选取207例于2014年2月至2016年2月就诊的乳腺肿块患者为研究对象,所有患者均采取SWE和乳腺影像报告与数据系统(BI-RASD)判断肿块的性质,比较乳腺良恶性病变的弹性模量值以及在临床诊断中的应用价值。结果 207例患者病理确诊良性病变175个和恶性病变60个。其中乳腺纤维瘤以及乳腺病在SWE成像中主要表现为均一的蓝色,炎性脓肿同样以蓝色为主,但其内部可伴有未着色部位;浸润性导管癌、浸润性小叶癌以及导管内癌主要表现为杂乱无章的红色,导管内乳头状癌主要表现为蓝色,同时可见红色以及无着色部位。和良性病变相比,恶性结节的弹性最大值以及弹性平均值更大,差异具有统计学意义(P均<0.01);乳腺弹性最大值和BI-RASD分级相比其诊断乳腺疾病的敏感性、特异性、准确度更占优势。结论在乳腺实性肿块诊断中应用SWE技术简单方便,能将病灶的弹性值清晰显示,有助于对病灶内部的硬度及组织特征做出客观及量化判断,为乳腺肿块的良恶性提供鉴别依据。
Objective To improve the clinical diagnosis of benign and malignant breast lesions, analyze the value of shear wave ultrasound elastography (SWE) in diagnosis and treatment. Methods Totally 207 patients with breast lump treated from February 2014 to February 2016 were enrolled in the random number table. All patients underwent SWE and BI-RASD to determine the quality of lumps, To compare the elastic modulus of benign and malignant breast lesions and its value in clinical diagnosis. Results A total of 207 benign lesions and 60 malignant lesions were identified in 207 patients. Breast fibromatosis and breast disease in the SWE imaging mainly in the blue uniform, inflammatory abscess also blue, but its internal may be associated with non-staining sites; invasive ductal carcinoma, invasive lobular carcinoma and catheter The main manifestations of internal cancer disorderly red, intraductal papillary carcinoma mainly blue, visible red and non-colored parts. Compared with benign lesions, the maximum and elastic mean values of malignant nodules were larger (P <0.01), and the sensitivity of maxillary elasticity and BI-RASD in diagnosis of breast diseases , Specificity, accuracy is more dominant. Conclusion The application of SWE in the diagnosis of solid breast masses is simple and convenient, and the elasticity value of the lesions can be clearly displayed, which helps to make objective and quantitative judgments on the hardness and tissue features of the lesions and provide the basis for the identification of benign and malignant breast masses .