超声光散射成像系统在乳腺肿块鉴别诊断中的应用

Application of diffused optical tomography with ultrasonography in differential diagnosis of breast neoplasms

目的探讨超声光散射双模式成像系统在乳腺肿块良、恶性鉴别诊断中的应用价值。方法采用超声光散射双模式成像系统，检查113例共123个乳腺肿块，并与术后病理进行对照。系统将肿块二维超声特征作数字化处理，并检测肿块组织营养代谢指标血红蛋白总量（HBT）和血氧饱和度（SO2），最终将二维超声信息和营养代谢参数综合处理，得出综合诊断指数（SDI）。分别计算二维超声、光散射和双模式鉴别诊断乳腺良、恶性肿块的敏感度、特异度、正确率。结果123个乳腺肿块中，良性肿块78个，恶性肿块45个。良性肿块内HBT为（153．02±105．78）明显低于恶性肿块内HBT（232．95±78．22）；良性肿块内sO2（1．0332±0．1641）明显高于恶性肿块内S02（0．8794±0．1814）；良性肿块内SDI（147．23±53．76）明显低于恶性肿块（243．98±57．27），两组之间比较有统计学意义（P〈0．05）。超声光散射双模式诊断系统鉴别诊断乳腺肿块的敏感度为93．33％，特异度为83．33％，准确率为86．99％。结论在二维超声的基础上联合应用光学技术检测组织的营养代谢可提高鉴别乳腺肿块性质的特异度，提高恶性病例早期诊断的正确率。

Objective To explore the value of diffused optical tomography（DOT） with uhrasonography （US） in differential diagnosis of breast benign from malignant neoplasms. Methods One hundred ard twenty-three breast neoplasms from 113 patients were checked use the optical tomography image ultrasonography（OPTIMUS）. The diagnosis results of the system were compared with pathological study. Two dimensional ultrasound features in breast neoplasms were digitalizated, and HBT and SO2 were detected by DOT. At last, synthesis diagnostic index（SDI） was obtained by both US and DOT. Statistic process was carried out in sensitivity,specificity,and the rate of accuracy respectively by US,DOT and OPTIMUS system. Results Among breast neoplasms of 123 mass studied pathologically,78 of them were benign and the rest were malignant. HBT in benign lesions （153. 02 ± 105.78） was significantly less than malignant lesions （232.95 ± 78.22）, SO2 in benign lesions （1. 0332 ± 0.1641 ） was significantly elevated compared with malignant lesions（0. 8794±0. 1814）, SDI in benign lesions（147.26± 53.76） was significantly less than malignant lesions（243.98 ± 57.27）, significant differences were found between the two groups （ P 〈0.05）. The sensitivity of differential diagnosis of breast neoplasms by the OPTIMUS system was 93.33 % , the specificity was 83.33 %, and the rate of accuracy was 86.99 %. Conclusions OPTIMUS can improve the specificity and the rate of early diagnosis.