目的 分析乳腺占位性病变采用超声成像诊断的价值。方法 选取2021年6月至2024年5月来本院就诊的328例乳腺占位性病变患者进行研究,所有患者均接受超声检查,并以病理诊断结果为金标准,分析超声成像对乳腺占位性病变的诊断准确性、灵敏度、特异度以及对不同类型病变的诊断特征。结果 328例乳腺占位性病变患者中,经最终病理诊断恶性28例,良性300例,其中乳腺癌28例,乳腺小叶增生80例,乳腺纤维腺瘤165例,乳腺复杂性囊肿45例,乳腺脂肪瘤10例。超声成像诊断结果显示恶性30例,良性298例,误诊3例,漏诊1例,诊断灵敏度96.43%（27/28）,特异度99.00%（297/300）,准确率98.78%（324/328）,与病理诊断一致性检验,Kappa=0.842,与病理诊断结果的一致性非常高。恶性病变形态不规则、边缘不光滑、内部回声不均匀、腋窝淋巴肿大、后方回声减弱以及纵横比≥1占比均高于良性病变（P<0.05）。结论 超声是一种无创、便捷且经济的影像学检查方法,在乳腺占位性病变诊断中具有高灵敏度、高特异度,与病理诊断结果的高度一致性,不仅能够提供丰富的形态学特征,还能有效区分恶性与良性病变,具有重要的临床应用价值。

Objective To analyze the diagnostic value of ultrasound imaging in breast space occupying lesions. Methods A total of 328 patients with breast space occupying lesions who visited our hospital from June 2021 to May 2024 were selected for the study. All patients underwent ultrasound examination, and the pathological diagnosis results were used as the gold standard to analyze the diagnostic accuracy, sensitivity, specificity, and diagnostic characteristics of ultrasound imaging for different types of breast space occupying lesions. Results Among 328 cases of breast space occupying lesions, 28 cases were malignant and 300 cases were benign, including 28 cases of breast cancer, 80 cases of lobular hyperplasia, 165 cases of fibroadenoma, 45 cases of complex cyst of breast, and 10 cases of lipoma of breast. The ultrasound imaging diagnosis results showed 30 cases of malignancy, 298 cases of benign, 3 cases of misdiagnosis, and 1 case of missed diagnosis. The diagnostic sensitivity was 96.43% (27/28), the specificity was 99.00% (297/300), and the accuracy was 98.78% (324/328). The consistency test with pathological diagnosis showed a Kappa value of approximately 0.842, which is very consistent with the pathological diagnosis results. The proportion of malignant lesions with irregular morphology, uneven edges, uneven internal echoes, axillary lymphadenopathy, weakened posterior echoes, and aspect ratio ≥ 1 is higher than that of benign lesions (P<0.05). Conclusions Ultrasound is a non-invasive, convenient, and economical imaging examination method with high sensitivity, specificity, and high consistency with pathological diagnosis results in the diagnosis of breast space occupying lesions. It can not only provide rich morphological features, but also effectively distinguish malignant and benign lesions, and has important clinical application value.