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目的探讨二维超声(2DUS)、超声弹性成像(UE)评分、三维超声(3DUS)汇聚征及三者联合应用对直径≤2.0cm乳腺实性结节良恶性鉴别诊断价值。方法分别应用2DUS、UE评分及3DUS冠状面汇聚征对413例患者共432个病灶(最大径≤2.0cm)图像进行检查诊断,以病理结果为金标准,通过受试者工作特性(ROC)曲线下面积的比较,比较三者单独及联合应用的鉴别诊断价值。结果病理为良性者159例共167个病灶,恶性者254例共265个病灶,2DUS、UE评分、3DUS冠状面汇聚征以及联合应用(并联和串联法)的ROC曲线下面积分别为0.732±0.022、0.909±0.015、0.861±0.016、0.795±0.019和0.825±0.015。并联法联合检测诊断小乳腺癌的灵敏度为98.49%,高于2DUS 80.00%、UE 93.21%、3DUS 81.13%及串联法65.66%(P<0.001)。结论 UE评分较2DUS和3DUS汇聚征对鉴别直径≤2.0cm的良恶性乳腺实性结节更具价值。并联法联合检测可提高诊断的灵敏度,有助于早期乳腺癌的检出率。
Objective To investigate the differential diagnosis of benign and malignant breast solid nodules (diameter ≤2.0 cm) using two-dimensional ultrasonography (2DUS), ultrasound elastography (UE), 3DUS confluence and their combination. Methods The images of 432 lesions (maximum diameter ≤ 2.0 cm) in 413 patients were diagnosed by 2DUS, UE score and 3DUS coronal polyphase collection respectively. The pathological results were taken as the gold standard, and the ROC curve Under the area of comparison, the three alone and combined application of the differential diagnosis value. Results A total of 167 lesions were diagnosed in 159 patients with pathologically benign lesions and 265 lesions were malignant in 265 lesions. The area under the receiver operating characteristic (ROC) curve of 2DUS, UE score, 3DUS coronal polyphasia and combined application (parallel and series methods) were 0.732 ± 0.022 , 0.909 ± 0.015, 0.861 ± 0.016, 0.795 ± 0.019, and 0.825 ± 0.015. The sensitivity of the parallel method in detecting small breast cancer was 98.49%, higher than 80.00% in 2DUS, 93.21% in UE, 81.13% in 3DUS and 65.66% in tandem method (P <0.001). Conclusions The UE score is more valuable than the 2DUS and 3DUS confluence in identifying benign and malignant breast nodules with diameter ≤2.0cm. Parallel detection of joint law can improve the diagnostic sensitivity, contribute to the detection rate of early breast cancer.