二维及多普勒超声诊断乳腺肿块的临床应用价值

The clinic value of B-mode and Doppler ultrasound in breast tumor

目的评价二维及多普勒超声对乳腺肿块鉴别诊断的临床应用价值。方法172例女性乳腺肿块患者,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形态、边缘、包膜、内部回声、肿物后方回声、皮肤浸润、微钙化及纵横比鉴别诊断乳腺肿块的敏感度为88.7%,特异度为56.6%。二维超声联合CDFI血流信号分级(恶性Ⅱ-Ⅲ级,良性0-Ⅰ级),PSV≥14cm/s,RI≥0.74,及PDI分型(恶性Ⅲ-Ⅳ型,良性Ⅰ-Ⅱ型),88.7%,特异度为80.5%。二者比较,特异度差异有统计学意义(P<0.02),敏感度差异无统计学意义(P>0.05)。结论在二维超声的基础上联合CDFII和PDI鉴别诊断乳腺肿块,明显提高了诊断恶性乳腺肿块的特异性。

Objective To evaluate the clinical value of B - mode and Doppler ultrasound in differentiation of breast tumor. Methods 172 consecutive patients with breast tumor were prospectively assessed by two dimensional ultrasound, color and power Doppler ultrasound before operation. Results Based on the two dimensional sonographic features, the differential diagnostic sensitivity, specificity and accuracy for the breast tumors were 88.7% and 56.6% respectively. Based on the color Doppler signal score, PSV ≥ 14vcm/s, RI ≥0. 74 and the features of flow in power Doppler, the differential diagnostic sensitivity and specificity accuracy were 81.7% and 66. 0% respectively. Integrating with B -mode, color and power Doppler, the differential diagnostic sensitivity, specificity and accuracy were 87. 3% and 80. 5%. Compared with two results, the specificity were improved（P 〈 0. 02）. Conclusion Combinational application of B - mode ultrasound, color Doppler and power Doppler ultrasound will improve the accuracy for diagnosis of breast tumour.