多指标积分法在乳腺癌早期诊断中的应用

Application of Multi-index Integral Method in Early Diagnosis of Breast Cancer

分析乳腺实性小结节的超声声像图特征,探讨超声及其多指标积分法鉴别诊断乳腺良恶性小结节的临床价值。42例乳腺实性小结节患者,经手术及病理检查证实良性结节21个、恶性结节35个,分析其术前超声影像学资料,并采用多指标积分法对其二维声像图特征及彩色多普勒血流成像特点予以评分,并与病理结果作对照。42例患者,经超声检查诊断为恶性结节33个、良性结节23个,恶性结节诊断符合率94.29%(33/35)。乳腺癌声像图特征包括结节内实质性低回声肿块、形态不规则、纵横比≥1、肿块边缘呈毛刺样、分叶状及成角改变、内部回声不均匀有微小钙化、内部血流丰富。23个良性结节多指标积分平均1.82±0.36,33个恶性结节多指标积分平均3.35±0.67,二者比较差异有统计学意义(P<0.01)。以超声多指标积分≥4分为结节良恶性分界值,误诊1例。超声及其多指标积分法对乳腺小结节的诊断有重要意义,超声积分能对乳腺小结节声像特征进行量化分析,降低误诊率,提高良恶性结节评估准确性。

This paper tried to analyze ultrasonic uhrasonographic features of breast solid nodules, and explore the clinical value of the ultrasonic differential diagnosis and multi -targets integral method in breast benign and ma- lignant nodules. Forty -two cases with breast solid nodules were confirmed by surgery and pathological examina- tion, with the result being 21 benign nodules and 35 malignant nodules. By the analysis of the ultrasound ima- ging data before the operation, two - dimensional ultrasonographic features and color doppler flowing image char- acteristics were graded by the method of multi- index integral and were compared with pathological results. A- mong the 42 patients, 33 malignant nodules and 23 benign nodules were diagnosed by the ultrasound, with the coincidence rate of malignant nodules diagnosis being 94 29% （33/35）. The ultrasonographic features of breast cancer include ubstantial well - defined hypoechoic mass lesion in the nodules, irregular shape, aspect ratio ≥ 1,a burr in the edge of bump, lobulated and rim angle change, uneven internal echo with tiny calcification as well as rich internal blood flow. The averaged index was （ 1.82 ± 0.36） in 23 benign nodules, and the averaged index was（3.35 ± 0.67 ） in 33 malignant nodules, with the comparative difference being statistically significant （ P 〈 0.05 ）. The value of ultrasonic integral≥ 4 was boundary value of benign ormalignant nodules, with only one case misdiagnosed. It is concluded that multi - index integral method is very important in diagnosis of breast nod- ules, and the ultrasonic integral can analyze the audio - visual characteristic of breast nodules, reduce the misdi- agnosis rate, as well as increase the evaluation accuracy of benign and malignant nodules.