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目的 比较超声检查和核素显像的结果 ,探讨核素在超声诊断乳腺病变中是否能够提供有效的帮助。方法 我院 1996 - 1999年经手术病理证实为乳腺恶性肿瘤病人 6 9例 ,良性病变 5 1例 ,术前均经彩色多普勒超声和99mTc -甲氧基异丁腈 (MIBI)显像检查 ,由多位检查者根据诊断标准和经验作出诊断。结果 超声诊断恶性病例 72例 (真阳性 6 5例 ,假阳性 7例 ) ;诊断良性病例 48例 (真阴性 44例 ,假阴性 4例 )。核素检查的相应值为恶性 73例(5 7,16 ) ;良性 47例 (35 ,12 )。超声诊断 12 0例乳腺肿块的敏感性、特异性、阳性预测值和阴性预测值分别为94 2 %、86 3%、90 3%和 91 6 % ;核素相应的数值为 82 6 %、6 8 6 %、78 1%和 74 4% ,它们之间的差异经 χ2 检验具有统计学意义。结论 超声比核素具有更高的准确性 ,当超声不能作出明确诊断时 ,结合核素显像可增加对恶性肿瘤的检出 ,但这种增加存在着假阳性上升的可能。
Objective To compare the results of ultrasonography and radionuclide imaging to explore whether radionuclide can provide effective help in diagnosing breast lesions by ultrasound. Methods Totally 69 patients with breast cancer and 51 benign lesions confirmed by operation and pathology in our hospital from 1996 to 1999 were examined by color Doppler ultrasonography and 99mTc-methoxyisobutyronitrile (MIBI) imaging before operation , By a number of examiners based on diagnostic criteria and experience to make a diagnosis. Results 72 cases of malignant ultrasound diagnosis (true positive 65 cases, false positive 7 cases); diagnosis of benign cases in 48 cases (true negative in 44 cases, 4 cases of false negative). The corresponding values for radionuclide examination were malignant in 73 cases (57,16%) and benign in 47 cases (35,12). The sensitivity, specificity, positive predictive value and negative predictive value of ultrasound in the diagnosis of breast masses were 94 2%, 86 3%, 90 3% and 91 6% respectively. The corresponding nuclide values were 82 6%, 6 8 6%, 78 1% and 74 4% respectively. The differences between them were statistically significant by χ2 test. Conclusion Ultrasound has higher accuracy than the nuclide. When ultrasound can not make a definite diagnosis, combined with nuclide imaging can increase the detection of malignant tumors, but there is a possibility of this false positive increase.