超微血管成像技术对乳腺肿瘤血管形态分布特征及其诊断效能的初步分析

Preliminary analysis of diagnostic efficiency of vascular morphology distribution in breast tumor by superb microvascular imaging

目的比较超微血管成像(SMI)和彩色多普勒血流成像(CDFI)检测乳腺肿瘤微血管的差异,探讨微血管形态特征在乳腺肿瘤良恶性鉴别诊断中的价值。方法选取在我院乳腺外科行手术治疗的105例患者(105个乳腺肿瘤),均于术前行SMI及CDFI检测,观察乳腺肿瘤微血管的形态学特征,与病理结果对比分析其诊断肿瘤良恶性的价值。结果SMI及CDFI模式下乳腺良恶性肿瘤的微血管形态分型差异具有统计学意义(P=0.021,0.042)。以无血管型、线型及树枝型为诊断良性肿瘤的依据,残根型及蟹足型为诊断恶性肿瘤的依据,SMI及CDFI诊断乳腺肿瘤的敏感性、特异性及准确性分别为85.36%、93.75%、90.47%及63.41%、90.47%、81.90%。两者ROC曲线下面积分别为0.896、0.786。Z检验结果显示两种方法的诊断效能差异有统计学意义(Z=2.265,P=0.037)。结论SMI比CDFI能更有效地检出乳腺肿瘤内的低速微小血管,其形态学分型在诊断肿瘤良恶性方面具有一定的临床意义。

Objective To compare the differences of superb microvascular imaging (SMI)and color Doppler flow imaging (CDFI)in the diagnosis of breast tumor microvessels and explore the value of microvascular morphological features in the detection of benign and malignant tumors.Methods SMI and CDFI were performed in 105 patients (105 breast tumors)in the breast surgery in our hospital.The morphological characteristics of the microvessels of the breast tumor were observed.Their values in the diagnosis of the benign and malignant of the tumor were compared with the pathological results.Results There were statistically differences in differentiation of microvascular morphologic types of benign and malignant breast tumors between SMI and CDFI (P =0.021,0.042).The type of diagnosing benign tumors was no blood vessel,linear and treelike.The type of diagnosing malignant tumors was root hair-like and crab claw-like.The susceptibility,specificity and accuracy of SMI and CDFI in diagnosing breast tumors were 85.36%,93.75%,90.47% and 63.41%,90.47%,81.90%.The area of the two ROC curves were 0.896 and 0.786.The results of the Z test show that the diagnostic efficacies of the two methods were statistically significant(Z =2.265,P =0.037).Conclusions SMI is more effective than CDFI in detecting low velocity microvessels in breast tumors.Its morphological typing is of clinical significance in the diagnosis of benign and malignant tumors.