三维超声汇聚征诊断乳腺癌

Retraction phenomenon on three-dimensional ultrasonography in diagnosis of breast cancer

目的探讨乳腺三维超声冠状面成像显示汇聚征诊断乳腺癌的价值。方法观察128例乳腺肿瘤患者(共132个病灶)的三维超声汇聚征和二维超声毛刺征显示情况,与病理结果对照,比较二者对乳腺癌的诊断价值,分析汇聚征显示率与肿瘤大小之间的关系。结果 132个乳腺肿块中,76个为乳腺癌,56个为乳腺良性病变,汇聚征和毛刺征诊断乳腺癌的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为63.16%(48/76)、92.86%(52/56)、75.76%(100/132)、92.31%(48/52)、65.00%(52/80)和44.74%(34/76)、91.07%(51/56)、64.39%(85/132)、87.18%(34/39)、54.84%(51/93)。汇聚征对于诊断乳腺癌的敏感度明显高于毛刺征(P<0.05)。汇聚征的显示率随着乳腺肿块直径增加而逐渐降低(P<0.01)。结论乳腺超声实时三维成像显示汇聚征对于乳腺癌的诊断价值高于二维超声显示毛刺征。汇聚征对于诊断乳腺癌具有较高特异度,对小乳癌有较高敏感度,对于早期乳腺癌的诊断和鉴别诊断具有重要价值。

Objective To explore clinical value of retraction phenomenon in coronal plane of three-dimensional ultrasonography （3DUS） in diagnosis of breast cancer. Methods Totally 128 patients with 132 breast tumors underwent conventional US and 3DUS. The presence of retraction phenomenon on 3DUS and the spiculation pattern on conventional US were compared with pathological results. Results There were 132 breast tumors, including 76 breast cancers and 56 benign neo- plasms. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of retraction and spiculation for breast cancer was 63.16~ （48/76）, 92.86% （52/56）, 75.76% （100/132）, 92.31% （48/52）, 65.00% （52/80） and 44.74% （34/76）, 91.07% （51/56）, 64.39% （85/132）, 87.18% （34/39）, 54.84% （51/93）, respectively. The diagnostic sensitivity of retraction phenomenon on 3DUS was significantly higher than that of spiculation pattern on conventional US （P〈0.05）. On 3DUS, she frequency of retraction phenomenon of breast cancer decreased significantly with increase of tumor diameter （P 〈 0.01）. Conclusion The diagnostic value of retraction phenomenon on 3DUS is higher than that of spiculation sign on conventional US for breast cancer. The retraction phenomenon has high specificity for diagnosing breast cancer and high sensitivity for diagnosing breast cancer with small diameter, playing an important role in differential diagnosis of early breast cancer.