应用ROC曲线分析彩色多普勒超声在乳腺肿瘤诊断中的价值

Analysis on the diagnostic value of color Doppler ultrasound in breast tumors by ROC curve

目的探讨彩色多普勒超声各指标在乳腺肿瘤诊断中的价值。方法对106例经手术病理确诊的乳腺疾病患者(56例良性,50例恶性)进行术前彩超检查,分析比较两组间高频声像图、彩色多普勒血流成像(CDFI)、病灶内血流Adler分级、阻力指数(RI)、峰值流速(PSV)的差异。同时采用ROC曲线分析各超声指标诊断恶性乳腺肿瘤的临床价值。结果良恶性乳腺肿瘤在形状、边界、纵横径比、内部回声、沙砾样钙化、后方回声衰减等方面差异有统计学意义(P<0.05),彩色多普勒显示乳腺癌内的血流较良性肿块明显丰富(P<0.05),乳腺癌的血管分布异常、频谱多普勒显示肿块内动脉血流PSV、RI显著高于良性肿块且差异有统计学意义(P<0.05),经ROC曲线分析显示Adler分级(AUC=0.935)、边界(AUC=0.905)对于鉴别诊断良恶性乳腺肿瘤具有较好的临床价值,其约登指数分别为0.844、0.811。结论彩色多普勒超声检查对鉴别乳腺良恶性肿瘤具有一定临床意义。

Objective To explore the value of each index of color Doppler ultrasound in diagnosis of breast tumors. Methods One hundred and six patients with breast tumors confirmed by pathological diagnosis （including 56 benign cases and 50 malig- nant cases） were examined prior to surgery by color Doppler sonography. We compared the differences in high - frequency ultra- sonic image, color Doppler flow imaging （CDFI）, Adler grade of blood flow, the resistance index （RI） and peak systolic velocity （PSV） between the two groups. The clinical value of each ultrasound index in diagnosis of malignant breast tumors was analyzed by using ROC curve. Results There were statistically significant differences in the indexes of shape, boundary, vertical and horizontal length ratio, internal echo, gravel - like calcification and posterior echo attenuation between the benign and malignant tumors （ P 〈 0.05 ）. The results of color Doppler ultrasound showed that the malignant tumors displayed more abundant bkxxt flow and abnormal vascular distribution compared with the benign tumors （ P 〈 0.05 ）. Spectral Doppler ultrasound displayed PSV and RI were significantly higher in malignant tumors than in benign tumors, with statistically significant differences （P 〈 0.05）. ROC curve analysis demonstrated that Adlers classification （AUC = 0. 935） and boundary （AUC = 0. 905 ） had a good clinical value in diagnosis of malignant breast tumor, and the Youden indexes were 0. 844 and 0. 811, respectively. Conclusions Color Doppler ultrasonography has certain clinical significance in the differential diagnosis of benign and malignant breast tumors.