三维能量多普勒超声鉴别乳腺良恶性肿瘤的价值

Value of three-dimensional power Doppler ultrasound in differentiating benign and malignant breast tumors

目的评价三维能量多普勒超声鉴别乳腺良恶性肿瘤的价值。方法乳腺肿块(恶性98例,良性108例)患者进行三维能量多普勒超声成像及直方图血管容积参数的采集与分析,直方图指数包括平均灰度、血管指数、血流指数和血管-血流指数。结果单因素分析以患者的年龄、肿瘤大小、肿瘤体积及血管各项指数鉴别乳腺良恶性肿瘤,参数之间差异均有统计学意义(P<0.05);鉴别病灶良恶性以肿瘤体积参数的准确性最高(80.2%),以血流指数的敏感性最高(73.8%),以血管指数、血管-血流指数的特异性为最高(均为90.3%)。多元Logistic逐步回归分析,模型(包括患者的年龄、体积及血流指数)是对乳腺恶性肿瘤定性诊断的最佳模型,此模型的ROC曲线下面积为0.958。结论三维能量多普勒超声能充分评估乳腺肿瘤的血管及血流情况,可以提高乳腺肿瘤的鉴别诊断能力。

Objective To evaluate the value of three - dimensional power Doppler ultrasound in differentiating benign and malignant breast tumors. Methods The patients with breast masses （ 98 malignant, 108 benign） were studied by three - dimensional power Doppler ultrasound imaging and vascular volume histogram. The histogram indexes included mean grayness （MG） , vascular index, （VI） , flow index（FI） and vascular flow index（VFI）. Results Benign and malignant breast tumors were differentiated by univariate analysis with patients age, tumor size, tumor volume and vascular indexes, there was significacnt difference among parameters （ P 〈 0.05 ）. Tumor volume had the highest accuracy （ 80.2% ）, FI had the highest sensitivity （73.8%） and VFI had the highest specificity （90.3%）, respectively. Multivariate and stepwise logistic regression revealed the model（ included patient age, volume and FI） was the best choice for malignant breast tumor characterization. The area under receiver operating characteristics （ ROC ） curve for the performance of the model was 0. 958. Conclusion Three - dimensional power Doppler ultrasound can evaluate the blood vessel and blood flow condition of breast tumors effectively, and it can improves the capability in differentiating between malignant and benign breast tmnors.