探讨"豹纹征"声像图特征诊断乳腺增生的临床价值。

2012年10月至2013年4月于北京友谊医院选取临床诊断为乳腺增生疾病且乳腺超声影像报告与数据系统分级为0级或1级的女性患者223例，分为20~35岁组（36例）、36~50岁组（102例）及>50岁组（85例）。超声引导下穿刺活检取得病理诊断结果。以病理诊断为金标准，以"豹纹征"图像为超声诊断标准，计算超声"豹纹征"诊断乳腺增生的敏感度、特异度、准确性、阳性预测值和阴性预测值；采用Kappa检验分析两者的一致性。

总样本223例诊断一致性检验：超声"豹纹征"图像诊断乳腺增生的敏感度为69%（59/85）、特异度为46%（64/138）、准确性为55%（123/223）、阳性预测值为44%（59/133）、阴性预测值为71%（64/90），与病理判断结果的一致性差（Kappa=0.14，P<0.05）。其中20~35岁组超声"豹纹征"图像诊断乳腺增生的敏感度为90%（18/20）、特异度为50%（8/16）、准确性为72%（26/36）、阳性预测值为69%（18/26）、阴性预测值为80%（8/10），与病理判断结果的一致性较好（Kappa=0.42，P<0.05）；36~50岁组超声"豹纹征"图像诊断乳腺增生的敏感度为70%（33/47）、特异度为49%（27/55）、准确性为59%（60/102）、阳性预测值为54%（33/61）、阴性预测值为66%（27/41），与病理判断结果的一致性差（Kappa=0.19，P<0.05）；>50岁组超声"豹纹征"图像诊断乳腺增生的敏感度为44%（8/18）、特异度为43%（29/67）、准确性为44%（37/85）、阳性预测值为17%（8/46）、阴性预测值为74%（29/39），与病理判断结果的一致性差（Kappa=0.08，P<0.05）。

"豹纹征"声像图不宜作为诊断乳腺增生的独立标准。

To study the diagnostic value of sonographic "Leopard pattern" sign in breast hyperplasia.

Two hundred and twenty-three female patients in Beijing Friendship Hospital from October 2012 to April 2013 were choosen. All the cases were diagnosed as mammary gland hyperplasia clinically, and their breast ultrasound images show the breast imaging-reporting and data system (BI-RADS) grad was 0 or 1. These patients were divided into 3 groups according to their age, Group A: 20 to 35 age (36 cases), Group B: 36 to 50 age (102 cases), and Group C: order than 50 year-old (85 cases). The pathological diagnosis were obtained by ultrasound guided breast biopsy. With pathological diagnosis as the gold standard and "Leopard sign" as ultrasound diagnostic criteria, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated. The consistency between the ultrasonic and the pathological diagnosis were analyzed by Kappa statistical test.

The diagnostic consistency test of the total sample of 223 cases: in terms of the ultrasonic Leopard sign" for the diagnosis of breast hyperplasia, the sensitivity was 69% (59/85),the specificity was 46% (64/138), the accuracy was 55% (123/223), the positive predictive value was 44% (59/133), the negative predictive value was 71% (64/90), the consistency was poor (Kappa=0.14, P<0.05). Group A:the sensitivity was 90% (18/20), the specificity was 50% (8/16),the accuracy was 72% (26/36), the positive predictive value was 69% (18/26), the negative predictive value was 80% (8/10), the consistency was good (Kappa=0.42, P<0.05);Group B:the sensitivity was 70% (33/47), the specificity was 49% (27/55),the accuracy was 59% (60/102), the positive predictive value was 54% (33/61), the negative predictive value was 66% (27/41), the consistency was poor (Kappa=0.19, P<0.05); Group C: the sensitivity was 44% (8/18), the specificity was 43% (29/67), the accuracy was 44% (37/85), the positive predictive value was 17% (8/46), the negative predictive value was 74% (29/39), the consistency was poor (Kappa=0.08, P<0.05).

"Leopard pattern" sign is not suitable as an independent standard in diagnosing breast hyperplasia disease.