超微血管成像技术对乳腺肿物的诊断价值

The diagnostic value of superb microvascular imaging for breast neoplasms

目的:对比分析超微血管成像(SMI)与彩色多普勒(CDFI)对乳腺肿物内血流显示的敏感性,并分别联合BI-RADS分级诊断标准,探讨超微血管成像(SMI)对乳腺肿物鉴别诊断的价值.方法:对82例乳腺肿物患者(88个病灶)进行双侧乳腺超声检查,按照Adler分级标准,分别观察同一肿物在CDFI和SMI中检出血流信号的差异,以病理结果结合BI-RADS分级诊断标准进行评价,分析SMI成像结合BI-RADS对评估乳腺肿物中的价值.结果:根据Adler分级标准分别用CDFI与SMI对乳腺良恶性肿物的血流进行观察,CDFI血流检出率为79.55%(70/88),SMI血流检出率为85.23%(75/88),且CDFI及SMI两种模式下判断良恶性肿物Adler分级均有统计学差异(P=0.017、P=0.02).在穿支血流方面,SMI对其的检出率更高,可作为肿物良恶性的诊断指标之一.与病理结果对照,SMI联合BI-RADS分级与CDFI联合BI-RADS分级诊断乳腺肿物的灵敏度分别为87.50%、82.50%,特异度分别为91.67%、89.58%,准确率分别为89.77%、87.50%,阳性预测值分别为89.74%、86.84%.阴性预测值分别为89.80%、86.00%,SMI联合BI-RADS分级诊断效能高于CDFI联合BI-RADS分级,但两者均没有统计学差异(P>0.05).结论:在显示乳腺肿物内微血管方面,SMI较CDFI更为敏感,SMI结合BI-RADS分级对诊断乳腺肿物性质具有重要临床价值.

Objective:Comparing the diagnostic sensitivity of superb microvascular(SMI)and color doppler flow imaging(CDFI)for the blood flow in breast neoplasms.Adopt BI-RADS grading diagnostic criteria to discuss the value of SMI in diagnose of breast neoplasms.Methods:Bilateral breast ultrasound was conducted on eighty-two patients(with eighty-eight lesions)using 2D gray-scale.According to Adler grading criteria for the diagnose of breast neoplasms,compare the blood flow of a single neoplasm detected by CDFI or SMI.Based on the pathological results and BI-RADS grading criteria,evaluate value of SMI imaging in for diagnosing breast neoplasms with BI-RADS grading criteria.Results:The blood flow of benign and malignant tumor in breast was graded with CDFI and SMI according to Adler grading standard.The detection rate of malignant blood flow with CDFI and SMI were 79.55%(70/88)and 85.23%(75/88)with statistically significant differences(P=0.017,P=0.02)respectively.SMI had a higher detection rate in perforator blood flow which can be regarded as one of the gold standards.Based on the pathological results,the diagnostic efficiency indicators of SMI with BI-RADS grading and CDFI with BI-RADS grading were as follow:sensitivity(87.50%,82.50%),specificity(91.67%,89.58%),accuracy(89.77%,87.50%),positive predictive value(89.74%,86.84%),and negative predictive value(89.80%,86.00%).The diagnostic efficiency of SMI-BI-RADS was higher than that of CDFI-BI-RADS,but differences were not statistically significant(P>0.05).Conclusion:Compared to CDFI,SMI is more sensitive in terms of displaying breast masses microvascular.SMI combining with BI-RADS grading diagnostic criteria plays an important role in breast tumor diagnosis and treatment.