小乳腺癌的彩色多普勒超声诊断

Diagnosis of the Small Breast Cancer with Color Doppler Imaging

本文报告经手术及病理证实直径≤２．０ｃｍ的乳腺肿物６１例，计７３个病灶的彩色多普勒（ＣＤＩ）超声检查结果。其中，恶性病变３９例，计４３个病灶；良性病变２２例，计３０个病灶。提出了我们的ＣＤＩ半定量分型标准（ＣＤＩ－ＨＱＡ）：Ⅰ型：病变区０～１处探及浅淡小点状血流信号，多单色、无彩色混叠现象，且血流信号主要出现于病灶周边部。Ⅱ型：病变区１～２处探及较亮点状，细条状血流信号，可有彩色混叠现象。血流信号以周边为主，偶见伸入病灶实质内。Ⅲ型：病变区３处以上探及明亮粗大点状和／或条状、树枝状血流信号，且病灶周边和实质内均易探及，并常有彩色混叠现象。我们将病灶血供属Ⅱ～Ⅲ型者，Ｖｍａｘ≥０．２０ｍ／ｓ和ＲＩ≥０．７０作为恶性肿瘤的阳性诊断指标；提出将其中二项以上指标呈阳性表现者作为小乳腺癌的诊断标准。结果本组诊断敏感性达９０．７％（３９／４３），特异性达９０％（２７／３０），准确性达９０．４％（６６／７３），优于彩色多普勒半定量、阻力指数或最高流速的单一指标分析法（Ｐ值＜０．０１），提高了彩超对≤２．０ｃｍ乳腺癌的诊断能力。初步结果表明，这种小乳腺癌彩超检查综合分析法，在临床应用中具有更客观准确、简便实用的优点。

Color Doppler Imaging (CDI) studies were performed on 61 cases with 73 small breast lesions (≤2.0cm),including 43 malignant and 30 benign lesions with pathological confirmed.Our result showed:Combining color Doppler imaging half quantitative analysis (CDI HQA) which the lesion blood supply belong to Ⅱ～Ⅲ type,if RI≥0.70 and or Vmax≥0.20m/s is regarded as a criterion for the diagnosis of malignant lesions,the sensitivty,spcificity and accuracy were 90.7%,90% and 90.4%,which were higher than analysis of the single CDI HQA and RI or Vmax ( P <0.01).It was shown that combined analysis of CDI was more objective and accurate for diagnosis of the small brease cancer.