Yoshihara K, Kisu T, Koizumi S, Matsuo Y, Matsubayashi R, Kudo S, Yamamoto W, Fukui T
Department of Internal Medicine, Soejima Hospital, Saga.
Fukuoka Igaku Zasshi. 1999 Feb;90(2):39-45.
We reviewed the medical records and images of 39 women with palpable breast masses, including 18 cases with breast cancer and 21 cases with benign breast mass, to compare diagnostic accuracy and clinical agreement between ultrasonography and mammography in breast cancer detection. We showed that the operating characteristics of ultrasonography, including sensitivity, specificity and positive likelihood ratio, were superior to that of mammography. We also confirmed that the established malignant criteria for malignancy, including lobulated shape, irregular contour and non-uniform internal echo in ultrasonography, and stellate mass in mammography, were statistically significant in distinguishing breast cancer from benign breast lesion. Moreover, the interobserver agreement kappa of ultrasonography and mammography were 0.64 and 0.59, respectively. Ultrasonography was also superior to mammography in attaining clinical agreement between the different observers in breast cancer detection.
我们回顾了39例可触及乳腺肿块女性的病历和影像资料，其中包括18例乳腺癌患者和21例乳腺良性肿块患者，以比较超声检查和乳腺X线摄影在乳腺癌检测中的诊断准确性和临床一致性。我们发现，超声检查的操作特性，包括敏感性、特异性和阳性似然比，均优于乳腺X线摄影。我们还证实，超声检查中确定的恶性标准，包括分叶状形态、不规则轮廓和不均匀内部回声，以及乳腺X线摄影中的星状肿块，在区分乳腺癌与乳腺良性病变方面具有统计学意义。此外，超声检查和乳腺X线摄影的观察者间一致性kappa分别为0.64和0.59。在乳腺癌检测中，不同观察者之间的临床一致性方面，超声检查也优于乳腺X线摄影。
