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目的探讨钼靶X射线摄影和高频超声检查对乳腺恶性病变的诊断效能。方法对山东中医药大学附属医院2013年3月至2014年2月收治检查乳腺恶性肿瘤患者42例分别进行钼靶X射线摄影和高频超声检查,另以具有可比性的乳腺良性病变患者30例为对照组,比较两组诊断效能。结果高频超声诊断阳性37例(51.39%),主要表现为边界模糊蟹足状低回声,肿块周围血供丰富,并伴有砂砾样钙化灶;X射线摄影诊断阳性40例(55.56%),主要表现为毛刺状肿块及不规则点簇状钙化影。B超组阳性率高于X射线摄影,但差异并无统计学意义(P>0.05);高频超声诊断灵敏度83.33%,特异度93.33%,假阳性率6.67%,假阴性率16.67%,约登指数83.26%,Kappa值87.50%,ROC曲线下面积AB超=0.903,钼靶X射线摄影灵敏度92.86%,特异度96.67%,假阳性率3.33%,假阴性率7.14%,约登指数89.53%,Kappa值94.44%,曲线下面积AX射线=0.917,两组比较差异具有统计学意义(P<0.05),钼靶X射线诊断效能较高。结论钼靶X射线摄影和高频超声检查对乳腺恶性病变诊断各有优劣,但钼靶X射线摄影总体诊断效能高于高频超声诊断。
Objective To investigate the diagnostic efficacy of mammography and high-frequency ultrasonography in the diagnosis of breast malignant lesions. Methods Forty-two patients with malignant tumor of breast cancer admitted to Shandong University of Chinese Medicine Hospital from March 2013 to February 2014 were examined by mammography and high frequency ultrasonography respectively. Another 30 patients with benign breast lesions were compared For the control group, the diagnostic efficacy of the two groups was compared. Results 37 cases (51.39%) were diagnosed by high frequency ultrasonography. The main manifestations were borderline fuzzy crab foot hypoechoic, abundant blood supply around the tumor and gritty calcification. Forty cases (55.56%) were diagnosed by X-ray photography, Mainly for the burr-like tumor and irregular clusters of calcification. The positive rate of B ultrasound was higher than that of X-ray photography, but the difference was not statistically significant (P> 0.05). The diagnostic sensitivity of high-frequency ultrasound was 83.33%, specificity was 93.33%, false positive rate was 6.67%, false negative rate was 16.67% The index of under-registration was 83.26% and the Kappa value was 87.50%. The area under the ROC curve was AB = 0.903. The sensitivity of mammography was 92.86%, the specificity was 96.67%, the false positive rate was 3.33%, the false negative rate was 7.14% and the Youden index was 89.53% , Kappa value of 94.44%, the area under the curve AX = 0.917, the difference between the two groups was statistically significant (P <0.05), mammography X-ray diagnosis of high efficiency. Conclusion Both mammography and high-frequency ultrasonography have their own advantages and disadvantages in the diagnosis of malignant breast lesions. However, the overall diagnostic efficiency of mammography is higher than that of high-frequency ultrasound.