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目的探讨超声造影技术(CEUS)与三维超声成像检查对乳腺良恶性结节的鉴别诊断价值。方法对89例乳腺肿块患者,共计113个病灶分别进行CEUS及三维超声成像检查,分析两种方法的病灶特点,并根据术后病理检查结果进行诊断学效能评价。结果根据术后病理检查结果分为恶性结节51例、良性结节62例,三维超声成像在113个乳腺良恶性结节良恶性鉴别中均具有显著差异(P<0.05)。CEUS检查在增强、边缘强化及增强程度方面对良恶性鉴别均具有显著差异(P<0.05);在消退模式方面CEUS鉴别良恶性差异不显著(P>0.05)。三维超声成像检查鉴别结节的灵敏度,特异度、阳性预测值、阴性预测值,与病理学检查结果的一致性Kappa值均高于CEUS;两者联合检查的灵敏度为96.08%、特异度为95.16%、漏诊率为4.84%、误诊率为3.92%、阳性预测值为94.23%、阴性预测值为96.72%、Kappa为0.911。结论对乳腺良恶性结节鉴别诊断,单独应用三维超声成像的诊断效能与单独使用CEUS检查相当,将两者联合应用能够显著提高术前诊断与术后病理诊断的一致性。
Objective To investigate the diagnostic value of contrast-enhanced ultrasonography (CEUS) and three-dimensional ultrasonography in the differential diagnosis of benign and malignant breast nodules. Methods A total of 113 lesions in 89 breast masses were examined by CEUS and three-dimensional ultrasonography respectively. The features of the two methods were analyzed. The diagnostic efficacy was evaluated according to the postoperative pathological findings. Results According to the results of postoperative pathological examination, there were 51 cases of malignant nodules and 62 cases of benign nodules. There was a significant difference (P <0.05) between three-dimensional ultrasonography and benign and malignant nodules in 113 benign and malignant breast lesions. There was a significant difference (P <0.05) between CEUS and CEUS in enhancement, margin enhancement and enhancement. There was no significant difference in CEUS between CEUS and CEUS (P> 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of three-dimensional ultrasonography in identifying nodules were all higher than those of CEUS. The sensitivity and specificity of combined detection of three-dimensional ultrasonography were 96.08% and 95.16 respectively %, Misdiagnosis rate was 4.84%, misdiagnosis rate was 3.92%, positive predictive value was 94.23%, negative predictive value was 96.72%, Kappa was 0.911. Conclusion The differential diagnosis of benign and malignant breast lesions, the single application of three-dimensional ultrasound imaging diagnosis of CEUS alone and comparable, the combination of the two can significantly improve the consistency of preoperative diagnosis and postoperative pathological diagnosis.