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目的探讨ABVS联合超声弹性成像鉴别乳腺小病灶良恶性的诊断价值。方法常规超声在健康查体者136人中检出178个乳腺小病灶,对这些小病灶再进行ABVS、超声弹性成像检查及病理学检查,并做出相应诊断。以病理学诊断为金标准,采用ROC分析方法计算“恶性”病变检出的敏感度、特异性、阳性预测值、阴性预测值及准确率。结果 178个小病灶的病理学诊断为:恶性病变62个,良性病变116个;ABVS诊断为:恶性病变71个,良性病变107个;超声弹性成像诊断为:恶性病变79个,良性病变99个。ABVS诊断“恶性”病变的敏感度88.71%、特异性86.21%、阳性预测值77.46%、阴性预测值93.45%、准确率87.08%;超声弹性成像诊断“恶性”病变的敏感度93.55%、特异性81.90%、阳性预测值73.42%、阴性预测值95.96%、准确率85.96%;ABVS联合超声弹性成像诊断时,至少一方提示恶性病变即判断为“恶性”的敏感度98.39%、特异性67.24%、阳性预测值61.62%、阴性预测值98.73%、准确率78.09%;两方均提示为恶性病变方判断为“恶性”的敏感度82.26%、特异性100.00%、阳性预测值100.00%、阴性预测值91.33%、准确率93.82%。结论 ABVS联合超声弹性成像可提高鉴别乳腺小病灶良恶性的诊断效力。
Objective To investigate the diagnostic value of ABVS combined with ultrasound in the differential diagnosis of benign and malignant breast lesions. Methods A total of 178 small breast lesions were detected in 136 healthy volunteers by conventional ultrasound, and ABVS, ultrasonography and pathological examination were performed on these small lesions and the corresponding diagnosis was made. With pathological diagnosis as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of “malignant” lesions were calculated by ROC analysis. Results The pathological diagnosis of 178 small lesions was as follows: 62 malignant lesions and 116 benign lesions. The diagnosis of ABVS was as follows: 71 malignant lesions and 107 benign lesions. Ultrasound elastography showed 79 malignant lesions and 99 benign lesions . The sensitivity of ABVS in diagnosis of “malignant” lesions was 88.71%, specificity was 86.21%, positive predictive value was 77.46%, negative predictive value was 93.45%, accuracy rate was 87.08%. The sensitivity of ultrasonic elastography in diagnosing “malignant” lesions was 93.55 %, Specificity of 81.90%, positive predictive value of 73.42%, negative predictive value of 95.96%, accuracy of 85.96%; ABVS combined ultrasound elastography diagnosis, at least one side of the malignant lesions that is judged as “malignant” sensitivity of 98.39% , The specificity was 67.24%, the positive predictive value was 61.62%, the negative predictive value was 98.73% and the accuracy rate was 78.09%. The sensitivity and the specificity of both malignant and malignant lesions were 82.26% and 100.00% The predicted value was 100.00%, the negative predictive value was 91.33% and the accuracy rate was 93.82%. Conclusion ABVS combined with ultrasound elastography can improve the diagnostic efficacy of differential diagnosis of benign and malignant breast lesions.