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目的 探讨弹性指数差(EID)鉴别乳腺BI-RADS 3~5类肿块良恶性的应用价值。方法 回顾分析164例经病理证实的BI-RADS 3~5类乳腺肿块患者(193个病灶)的超声检查资料。通过弹性成像定量分析软件测定肿块与正常腺体间的EID。以EID≥2.5判断为恶性,重新调整BI-RADS分类。绘制ROC曲线并计算曲线下面积(AUC)。比较BI-RADS联合EID与单独应用BI-RADS分类诊断乳腺恶性肿块的AUC及诊断准确率。结果 以病理结果为金标准,单独应用BI-RADS诊断乳腺恶性肿块的敏感度、特异度、准确率分别为96.00%、67.80%、78.76%;BI-RADS联合EID诊断乳腺恶性肿块的敏感度、特异度、准确率分别为97.33%、83.05%、88.60%。BI-RADS联合EID的AUC(0.931)高于单独应用BI-RADS的AUC(0.875),差异有统计学意义(Z=2.06,P<0.05);且两种方法的诊断准确率差异亦有统计学意义(χ2=15.21,P<0.05)。结论 BI-RADS联合EID对鉴别乳腺肿块良恶性较单纯应用BI-RADS更具优势。
Objective To investigate the value of differential elasticity index (EID) in differential diagnosis of benign and malignant tumors of breast masses BI-RADS. Methods A retrospective analysis of 164 cases of pathologically confirmed BI-RADS 3 to 5 breast masses (193 lesions) by ultrasonography was performed. The EID between lumps and normal glands was determined by elastography quantitative analysis software. To EID ≥ 2.5 to determine the malignant, readjust the BI-RADS classification. Draw ROC curves and calculate the area under the curve (AUC). The AUC and diagnostic accuracy of BI-RADS combined with EID and BI-RADS alone in the diagnosis of breast malignant tumor were compared. RESULTS: The sensitivity, specificity and accuracy of BI-RADS in the diagnosis of malignant breast mass were 96.00%, 67.80% and 78.76% respectively. The sensitivity of BI-RADS combined with EID in the diagnosis of malignant breast mass, Specificity and accuracy were 97.33%, 83.05% and 88.60% respectively. The AUC (0.931) of BI-RADS combined with EID was higher than that of BI-RADS alone (0.875), the difference was statistically significant (Z = 2.06, P <0.05). There was also a statistically significant difference in diagnostic accuracy between the two methods Significance (χ2 = 15.21, P <0.05). Conclusion The combination of BI-RADS and EID can identify benign and malignant breast masses better than BI-RADS alone.