多普勒超声在乳腺癌诊断中的应用

Application of Doppler Sonography in the Diagnosis of Mammary Carcinoma

目的探讨多普勒超声在乳腺癌诊断及鉴别中的应用价值。方法应用多普勒超声对170例经手术病理证实的乳腺肿块的病人进行了研究。彩色多普勒及能量多普勒用于探查肿块内部及周边是否有血流信号，观察血流信号的多少，并根据血流信号的多少将其分为0级、Ⅰ级、Ⅱ级、Ⅲ级。脉冲多普勒用于测量最大血流速度及阻力指数等血流动力学指标。结果良性肿块内血流信号以0～Ⅰ级为主，乳腺癌肿块内血流信号以Ⅱ～Ⅲ级为主，二者差异显著，（x^2=39.43,P〈0.01）。乳腺癌组最大血流速度为24.76±10.06cm/s，良性肿块最大血流速度为19.03±7.65cm/s。二者之间的差异有显著意义（t=3.64,P〈0.01）。乳腺癌组阻力指数为0.70±0.23，良性肿块阻力指数为0.60±0.14，二者之间的差异有显著意义（t=3.23,P〈0.01）。结论乳腺癌较良性肿块血流丰富，乳腺癌多表现为高阻力高流速血流。多普勒超声可显示乳腺良性肿块与乳腺癌在血流量、血流动力学指标方面的差异，对乳腺癌的诊断及鉴别有较大帮助意义。

Objective To explore the value of Doppler utra-sonography in the diagnosis of mammary carcinoma. Methods One hundred and seventy patients with mammary masses confirmed pathologically were examined with Doppler sonography. Color Doppler flow imaging （CDFI） and Power Doppler imaging （PDI） were used to determine if there were blood flow signals in the masses. According to the numbers and shape of blood flow signals found in masses, the signals were classified into four stages ： stage 0, stage Ⅰ , stage Ⅱ , and stage Ⅲ . The blood flow dynamic indexes such as the maximal blood flow velocity （Vmax） and the resistant index （RI） were measured with pulsed wave Doppler （PW）. Results The operation and pathological examination demonstrated that there were 76 benign masses and 94 malignant masses in the 170 patients. The CDFI and PDI showed that there were more blood signals in malignant masses than that in benign masses （x^2 = 39.43, P 〈 0. 01 ）. Most mammary malignant masses showed blood signals of stage Ⅱ -Ⅲ , on the other hand, most benign masses showed blood sgnals of stage 0 ～ Ⅰ .The Vmax of mammary eareinous masses was 24.76 ± 10.06 cm/s and benign lesions was 19.03 ± 7.65 cm/s, there was singnifieant diffrenee between them （t = 3.64, P 〈 0.01）. The RI of mammary malignant lesions was 0.70 ± 0.23, and of benign lesions was 0.60 ± 0.14, there was singnifieant diffrenee between them （ t = 3.23, P 〈 0.01 ）. Conclusion Mammary malignant masses are different from benign masses at the manifestation of CDFI, PDI PW Vmax and RI indexes, which has great value to the diaguosis of mammary carcinoma.