摘要
目的:分析超声引导下穿刺活检(US-CNB)诊断乳腺良恶性肿块的价值.方法:选取2022年4月-2024年3月本院收治的80例乳腺肿块患者,均行US-CNB检查,以肿块切除病理检查为"金标准",分析US-CNB鉴别乳腺肿块良恶性的效用;另对比性质不同乳腺肿块的超声图像差异.结果:80例乳腺肿块患者中,"金标准"共检出48例恶性,32例良性;US-CNB共检出47例恶性;以肿块切除病理检查结果为"金标准",US-CNB诊断乳腺肿块良恶性的灵敏度、准确度、特异度、阴性预测值、阳性预测值均＞90％;kappa检验显示:US-CNB与"金标准"的一致性极好(kappa值=0.922,P=0.000);恶性乳腺肿块的形态不规则占比为75.00％(36/48)、边缘模糊占比为83.33％(40/48)、内部回声分布不均匀占比为72.92％(35/48)、纵横比＞1占比为85.42％(41/48)、侧后声影不明显占比为68.75％(33/48),高于良性乳腺肿块的21.88％(7/32)、37.50％(12/32)、28.12％(9/32)、31.25％(10/32)、25.00％(8/32),差异有统计学意义(P＜0.05).结论:US-CNB 可有效诊断出乳腺肿块的良恶性,而乳腺肿块的性质不同,其超声图像特征亦有显著差异.
Abstract
Objective:To analyze the value of ultrasound-guided needle biopsy(us-cnb)in the diagnosis of benign and malignant breast masses.Methods:80 patients with breast masses treated in our hospital from April 2022 to March 2024 were selected and underwent us-cnb examination.Taking the pathological examination of mass resection as the"gold standard",the utility of us-cnb in differentiating benign and malignant breast masses was analyzed;In addition,the ultrasound images of breast masses with different properties were compared.Results:Among 80 patients with breast masses,48 cases were malignant and 32 cases were benign according to the"gold standard";A total of 47 malignant cases were detected by us-cnb;The sensitivity,accuracy,specificity,negative predictive value,and positive predictive value of us-cnb in the diagnosis of benign and malignant breast masses were＞90％based on the results of pathological examination of tumor resection as the"gold standard";Kappa test showed that:the consistency between us-cnb and the"gold standard"was excellent(kappa value=0.922,P=0.000);the proportion of irregular shape of malignant breast masses was 75.00％(36/48),the proportion of blurred edges was 83.33％(40/48),the proportion of uneven internal echo distribution was 72.92％(35/48),the proportion of aspect ratio＞1 was 85.42％(41/48),the proportion of lateral and posterior acoustic shadow was 68.75％(33/48),which was higher than that of benign breast masses 21.88％(7/32),37.50％(12/32),28.12％(9/32),31.25％(10/32)25.00％(8/32),the difference was statistically significant(P＜0.05).Conclusion:Us-cnb can effectively diagnose the benign and malignant breast masses,and there are significant differences in the ultrasonic image characteristics of breast masses with different properties.
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