多普勒超声对乳腺肿块鉴别诊断的研究

Clinical Study on Doppler Ultrasound in Differentiation of Breast Neoplasms

目的 评价多普勒超声对乳腺肿块鉴别诊断的临床应用价值。方法 60例女性患者 ,术前分别进行二维超声、彩色多普勒超声和能量多普勒超声检查。结果 根据肿块的二维超声图像特征边缘轮廓、包膜、侧方声影、内部回声、后壁回声、肿物后回声、组织浸润及纵横比鉴别诊断乳腺肿块的敏感度为 96.7% ,特异度为 60 % ,准确度为 78.3 %。二维超声联合CDFI血流信号分级 (恶性Ⅱ～Ⅲ级 ,良性 0～Ⅰ级 ) ,RI≥ 0 .7,PI≥ 1.1及PDI分型 (恶性Ⅲ～Ⅳ型 ,良性Ⅰ～Ⅱ型 ) ,CPD≥ 2 1%鉴别诊断乳腺肿块的敏感度为 93 .3 % ,特异度为 83 .3 % ,准确度为 88.4%。二者比较 ,特异度有显著性差异 (P<0 .0 2 ) ,敏感度和准确度无显著性差异 (P >0 .0 5 )。结论 在二维超声的基础上联合CDFI和PDI鉴别诊断乳腺肿块 ,明显提高了诊断恶性乳腺肿块的正确率 ,有很大的临床应用价值。

Objective To evaluate the clinical value of Doppler ultrasound in differentiation of breast neoplasms. Methods Sixty consecutive patients with breast neoplasms were prospectively assessed by two-dimensional ultrasound, color Doppler ultrasound and power Doppler ultrasound before operation. All were proved by pathology. Results Based on the two-dimensional ultrasound features the differential diagnosis sensitivity, specificity and accuracy for the breast neoplasms were 96.7%, 60% and 78.3% respectively. Based on the color Doppler signal scores and RI≥0.7 or/and PI≥1.1, the differential diagnosis sensitivity, specificity and accuracy were 86.7%, 70% and 78.3% respectively. Based on the power Doppler signal types and CPD≥21%,the differential diagnosis sensitivity, specificity and accuracy were 86.7%, 76.7% and 81.6% respectively. Integrating with the three methods, the differential diagnosis sensitivity, specificity and accuracy were 93.3%, 83.3% and 88.4%. Conclusion In this study, two-dimensional ultrasound integrating with color Doppler ultrasound and power Doppler ultrasound can differently diagnose the breast neoplasm.