摘要
目的探讨PCM和GLM临床表现、2D声像图、SMI血流分级及弹性成像的特征,以期提高其鉴别诊断水平。方法分析32例NLM患者的临床表现、2D声像图表现、SMI血流分级及弹性成像特征,统计分析并以ROC曲线评价有效参数的诊断效能。结果32例NLM患者中,PCM患者19例,GLM患者13例。两组患者发病诱因、乳头溢液、包块、触痛、皮肤损害、病灶位置及回声特点资料经Fisher精确检验,差异有统计学意义(P<0.05);两组血流分级、弹性评分经秩和检验,差异无统计学意义(P>0.05);两组弹性应变率比值经t检验,差异无统计学意义(P>0.05)。各参数Logic回归分析显示,发病诱因、乳头溢液、包块、触痛、皮肤损害、病灶位置及回声特点为鉴别诊断PCM和GLM的特征性因素,差异有统计学意义(P<0.05)。二级7参数联合鉴别诊断PCM和GLM的ROC曲线AUC=0.966均高于各参数AUC,其灵敏度=92.9%,特异度=95.8%。结论二级7类参数综合评价,能较好区分PCM和GLM,提高鉴别诊断效能。而SMI血流、弹性成像及弹性应变率对二者的鉴别价值有限。
Objective To explore the clinical features,2D image,SMI flow classification and elastography of PCM and GLM,in order to improve the differential diagnosis.Methods We analyzed the clinical manifestations,2D sonography,SMI classification and elastography of 32 patients with NLM.We statistically analyzed the data and evaluate the diagnostic efficacy of effective parameters with ROC curve.Results Among the 32 patients with NLM,19 were PCM patients and 13 were GLM patients.Patients in two groups,including the causes of the disease,nipple discharge,lumps,tenderness,skin lesions,location and echo characteristics of the data were accurately examined by fisher text,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups in blood flow grading and elastic score by rank sum test(P>0.05).There was no significant difference in strain rate ratio between the two groups by t test(P>0.05).Logic regression analysis of the parameters showed that the etiology,nipple discharge,lumps,tenderness,skin lesions,location and echo characteristics were characteristic factors between the PCM and GLM.The difference was statistically significant(P<0.05).The ROC curve AUC of the two class included 7 species parameters combined differential diagnosis PCM and GLM was 0.966,which was higher than the AUC of each parameter,and the sensitivity was 92.9%,the specificity was 95.8%.Conclusion The comprehensive evaluation of the two class including 7 species parameters can better distinguish PCM and GLM,and improve the effectiveness of differential diagnosis.The value of SMI blood flow,elastography and strain ratio is not significant to identify the two kinds of diseases.
作者
张开元
杨兵社
王静
左秀娟
汤巧
ZHANG Kaiyuan;YANG Bingshe;WANG Jing;ZUO Xiujuan;TANG Qiao(College of Medical Technology,Shaanxi University of Chinese Medicine,Xianyang 712046,P.R.China;Department of Ultrasound,The Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,P.R.China)
出处
《医学影像学杂志》
2019年第5期775-778,793,共5页
Journal of Medical Imaging
基金
陕西省中医药管理局中医药科研课题项目(编号:LCT7076)
作者简介
张开元(1989-),男,河南洛阳人,毕业于陕西中医药大学,硕士研究生,住院医师,主要从事医学超声诊断工作;通信作者:杨兵社,副主任医师,E-mail:18992058019@189.cn.
