多参数分析声像图特征鉴别乳腺良恶性肿瘤

Differential Diagnosis between Mammary Benign and Malignant Tumor by Analyzing the Multiple Parameters in Ultrasonic Feature

目的探讨多参数综合分析灰阶及彩色多普勒超声征象对乳腺良恶性肿瘤鉴别诊断的意义。方法选取经术后病理证实的乳腺癌119例,乳腺良性肿瘤47例,分析其声像图特征,包括乳腺肿块的内部及后方回声、边缘特征、血流分布、峰值流速(PSV)、阻力指数(RI)及血流频谱形态。结果乳腺癌和乳腺良性肿瘤的收缩期峰值流速(PSV)和RI分别为(21.17±13.43)cm/s(、0.84±0.12)及(13.21±7.23)cm/s、(0.70±0.17)。以PSV>15cm/s诊断乳腺癌的特异性为70.21%。微钙化、边缘毛刺、纵/横比>1和RI>0.7诊断乳腺癌的特异度、敏感度分别为76.60%、56.3%,80.85%、85.71%,93.62%、38.66%和74.47%、75.63%。超声诊断乳腺癌111例,良性肿瘤44例,诊断乳腺癌的准确性、特异度及敏感度分别为93.4%、93.6%、93.3%。结论二维及彩色多普勒超声征象多参数分析对诊断乳腺癌有重要价值。

Objective To explore the value of differential diagnosis between breast benign and malignant tumor by analyzing the multiple parameters in grayscale and color Doppler ultrasonic characteristics. Methods To analyze the sonographic characteristics of the 119 cases of mammary cancer and 47 cases of benign mammary tumor, including the internal and posterior echo, peripheral features, blood distribution, peak systolic velocity（PSV）, resistance index （RI） and blood spectral patterns. All cases were confirmed by pathology. Results The PSV, RI of breast cancer and benign mammary tumor were （21.17 ±13.43）cm/s, （0.84±0.12） and （13.21±7.23） cm/s, （0.70±0.17） respectively. The specificity of the PSV〉15crrds in diagnosis of breast cancer was 70.21%. The specificity of the microcalcification, edge burr, vertical / horizontal ratio 〉1 and RI〉0.7 in diagnosis of breast cancer were 76.60%, 80.85%, 93.62% and 74.47%, respectively, sensitivity were 56.3%, 85.71%, 38.66% and 75.63% respectively. In these cases, 111 breast cancer and 44 benign mammary tumor were diagnosed exactly by sonography. Ultrasound diagnosis of breast cancer, accuracy, specificity and sensitivity Were 93.4%, 93.6%, 93.3%, respectively. Conclusion It was important value to diagnose breast cancer by analyzing the multiple parameters in 2D and color Doppler ultrasonic characteristics.