常规超声与自动乳腺全容积成像对浸润性导管癌三维测量的对比分析

Comparative analysis on three-dimensional assessment of breast invasive ductal carcinoma by conventional ultrasound and automated breast volume scanner

目的比较常规超声与自动乳腺全容积成像(ABVS)三维测量浸润性导管癌大小的准确性。方法选取经病理证实的乳腺浸润性导管癌患者52例,常规超声与ABVS分别测量肿瘤最大直径,计算肿瘤体积、表面积;医学图像处理软件Mimics 17.0重建肿瘤的三维模型并计算肿瘤体积(Mimics体积)。分析常规超声、ABVS的测量值及Mimics体积与病理测值的相关性,并对其相关系数进行比较。以T2为临界点,ROC曲线分析各测量值对预测T2期肿瘤的准确性,并进行比较。结果常规超声所测最大直径、体积及表面积与病理测值的相关系数分别为0.543、0.639、0.650(均P=0.000),三者评估肿瘤大小的ROC曲线下面积分别为0.777、0.767、0.793;ABVS所测最大直径、体积和表面积与病理测值的相关系数分别为0.736、0.820、0.830(均P=0.000),三者评估肿瘤大小的ROC曲线下面积分别为0.885、0.921、0.902;Mimics体积与病理所测体积的相关系数为0.856(P=0.000),ROC曲线下面积为0.938。ABVS测量体积和面积的准确性均高于常规超声,差异均有统计学意义(P=0.018、0.040);在测量最大直径方面二者比较差异无统计学意义。结论二维测量参数与三维测量参数之间比较差异无统计学意义,但三维测量的准确性高于二维测量;ABVS测量肿瘤大小的准确性高于常规超声。ABVS测量肿瘤的三维大小是一种可靠的影像学方法,可更准确地反映肿瘤的形态特征和生物学特性。

Objective To compare the accuracy of conventional utrasonography（US）and automated breast volume scanner（ABVS）in three-dimensional assessment of primary breast invasive ductal carcinoma. Methods Fifty-two patients with invasive ductal carcinoma were included in our study. The maximal tumor diameter（MD）,the tumor volume（TV）and surface area（TSA）were calculated by US and ABVS. The volume measures were also obtained from ABVS data with a software dedicated to3 D reconstruction（Materialise ＇s interactive medical image control system 17. 0,Mimics）. The two- dimensional and three-dimensional parameters of US and ABVS,and Mimics volume were evaluated by calculating correlation coefficients when compared with pathological measurements. Taking T2 classification as the critical point,the accuracy of the measurements for predicting T2 classification was analyzed by the ROC curves,and the statistical significant differences were tested. Results The correlation coefficient of MD,TV and TSA of US and pathology was 0.543,0.639,0.650（all P =0.000）,and the area under the ROC curves of these three parameters were 0.777,0.767,0.793.The correlation coefficient of MD,TV and TSA of ABVS and pathology was 0.736,0.820,0.830（all P=0.000）,and the area under the ROC curves of these three parameters was 0.885,0.921,0.902,respectively. The correlation coefficient of Mimics volume and pathology was 0.856（P=0.000）,and the area under the ROC curves was 0.938. The accuracy of ABVS in measurement of volume and area was higher than that of US,there was significant difference（P = 0. 018,0. 040）,while there was no significant difference in measurement of MD. Conclusion There are no statistical significant differences between two-dimensional and three-dimensional parameters. However,the accuracy of three-dimensional parameters is higher than two-dimensional parameters. The accuracy of ABVS measurements is higher than US with statistical significant differences. ABVS is a reliable tool for three-dimensional measurements,which allows a more accurate morphologic and biological description of the lesions.