对比超声定位光散射断层成像与彩色多普勒血流显像检测乳腺癌血供

Comparison on breast tumor angiogenesis between ultrasound-guided diffuse optical tomography and color Doppler flow imaging

目的比较超声定位光散射断层成像（DOT）与CDFI检测乳腺癌血供的敏感性。方法 111例乳腺癌患者,经术后病理证实,共118个瘤灶。术前CDFI将乳腺癌血供分为血流丰富、中等及无血流。常规超声检查明确病变后定位行DOT,测量病变血红蛋白总浓度（THC）,以THC 140μmol/L为阈值,比较DOT与CDFI检测不同大小乳腺癌血流的敏感性。结果 118个乳腺癌瘤灶中,57个（48.31%）CDFI表现为血流丰富,36个（30.51%）中等血流,25个（21.19%）无血流;DOT检出99个癌灶（83.90%）的THC〉140μmol/L。对于≤1 cm、〉1~2 cm、〉2~3 cm、〉3 cm的乳腺癌,CD-FI血流显示率分别为28.57%（6/21）、90.20%（46/51）、86.21%（25/29）和94.12%（16/17）,THC增高率分别为76.20%、76.50%、93.10%和100%。结论 DOT可更敏感地检测乳腺癌血管,特别是对于诊断直径≤1 cm的早期乳腺癌,具有潜在临床应用价值。

Objective To compare the sensibility of ultrasound guided diffuse optical tomography（DOT） and color Doppler flow imaging（CDFI） for detection of breast cancer angiogenesis.Methods A total of 111 consecutive women with 118 breast cancers confirmed pathologically underwent CDFI and DOT before operation.CDFI appearances of the tumors were assessed and classified into abundant,median or absent of blood flow.After ultrasound localization,DOT was performed and the total hemoglobin concentration（THC） was measured.THC 140 μmol/L was chosen as the cutoff of DOT.The sensitivity of CDFI and DOT in detecting breast cancer angiogenesis was compared.Results In 118 breast cancers,57（48.31%） with abundant,36（30.51%） with median flow and 25（21.19%） without blood flow signals.DOT detected 99 tumors（83.90%） with elevated THC level.For tumors ≤1 cm,1—2 cm,2—3 cm and 3 cm,the percentage of blood flow detection on CDFI was 28.57%（6/21）,90.20%（46/51）,86.21%（25/29） and 94.12%（16/17）,while of THC elevation was 76.20%,76.50%,93.10% and 100%.Conclusion DOT can improve the detection ability of breast cancer angiogensis,therefore has potential clinical application value on diagnosis of early stage breast cancers less than 1 cm.