3D-PDS联合BI-RADS在乳腺良、恶性病灶鉴别诊断中的价值分析

Diagnostic value of 3D-PDS combined with BI-RADS in differential diagnosis of benign and malignant breast lesion

目的探讨三维能量多普勒超声(3D-PDS)联合超声乳腺影响报告与数据系统(BI-RADS)在乳腺良、恶性病灶鉴别诊断中的价值。方法选取行乳腺肿瘤切除术的260例患者,每位患者均于术前分别进行3D-PDS及BIRADS检查。术后取得病灶280个,根据病理检查结果,将280个病灶分为良性组(n=168)以及恶性组(n=112),对2组的3D-PDS特征以及二维BI-RADS特征进行比较,观察是否存在差异。以病理结果为金标准,绘制受试者操作特性曲线(ROC)曲线,比较单独采用3D-PDS、BI-RADS方法或两种方法联合使用在对乳腺良、恶性病灶的鉴别诊断中的诊断能力大小。结果 2组在血管形态、分布以及穿入血管的有无等方面比较差异均有统计学意义(P<0.01);并且2组在二维超声特征的比较上,2组病灶的形状大小、边界、生长方位、后方回声以及钙化等方面的比较差异均有统计学意义(P<0.05)。ROC曲线结果显示,单独采用3D-PDS、二维超声检查方法的曲线下面积分别为(0.796,0.691),而两者联合使用方法下的曲线下面积为(0.852),大于前两者。结论 3D-PDS联合BI-RADS在乳腺良、恶性病灶鉴别诊断中具有重要意义,能够提高病灶的鉴别诊断能力。

Objective To investigate the application value of 3 D-PDS combined with BI-RADS in differential diagnosis of benign and malignant breast lesion. Methods A total of 260 patients who underwent breast neoplasms resection were enrolled in the study. These patients were examined by BI-RADS and 3 D-PDS,then according to the examination results,these patients were divided into benign lesion group（ n = 168） and malignant lesion group（ n = 112）. The characteristics of3 D-PDS and 2 D BI-RADS were observed and compared between two groups. Moreover taking pathological examination results as gold standard to draw ROC curve,and the diagnostic value of simple 3 D-PDS or simple BI-RADS or combination detection of two methods in differential diagnosis of benign and malignant breast lesions was analyzed. Results There were significant differences in vascular morphous and distribution,the penetrating blood vessel between two methods（ P〈0. 01）. Moreover there were significant differences in tumor shape,size,growth direction,boundary,posterior acoustic features and calcification between the two methods（ P〈0. 05）. The ROC curve results showed that the area under curve（ AUC） of simple 3 D-PDS or simple BI-RADS was 0. 796,0. 691,respectively,which by combination detection of two methods was 0. 852,the latter was higher than that in simple detection by the former two methods. Conclusion 3 D-PDS combined with BI-RADS plays an important role in differential diagnosis of benign and malignant breast lesions,which can improve the differential diagnosis ability for the lesions.