乳腺超声自动容积成像联合超声造影微血管成像在乳腺病灶鉴别诊断及肿瘤TNM分期中的应用价值

Application value of breast ultrasound automatic volume imaging combined with contrast enhanced ultrasound microangiography in the differential diagnosis of breast lesions and TNM staging of tumors

目的探索乳腺超声自动容积成像联合超声造影微血管成像在乳腺病灶鉴别诊断及肿瘤TNM分期中的应用价值。方法收集乳腺肿块患者64例,入院后均行超声自动容积成像和超声造影微血管成像检查,将患者分为乳腺癌组和良性肿块组。比较超声造影微血管成像乳腺良恶性肿瘤血流检出率,分析诊断乳腺癌TNM分期与病理分期的符合率,评估超声造影微血管成像、全容积超声成像、二者联合的灵敏度、特异度。结果乳腺癌组造影后周边血流、内部血流检出率均明显高于良性肿块组(P<0.05)。所有乳腺癌TNM分期中,超声自动容积成像与病理符合率是58.82%,而超声造影微血管成像与病理符合率是85.29%,两者具体统计学差异(P<0.05)。二者联合成像的特异度显著高于单独超声造影微血管成像、自动容积成像诊断,差异有统计学意义(P<0.05)。两者联合诊断的Kappa最高,病理判断一致性最好。结论超声自动容积成像和超声造影微血管成像能准确客观地提供乳腺癌血管生成水平和病灶的结构变化,有助于乳腺癌的临床诊断。联合应用的灵敏度和病理结果一致性最好。

Objective To explore the application value of breast ultrasound automatic volume imaging combined with contrast-enhanced ultrasound microangiography in the differential diagnosis of breast lesions and TNM staging of tumors.Methods 64 cases of breast mass patients were collected.After admission,all patients underwent automatic volume ultrasound imaging and contrast-enhanced ultrasound microangiography,and were divided into breast cancer group and benign mass group.The blood flow detection rate of benign and malignant breast tumors by contrast-enhanced microangiography(ceus)was compared,and the coincidence rate of TNM staging and pathological staging of breast cancer were analyzed.The sensitivity and specificity of ceus microangiography and full-volume ultrasound imaging were evaluated.Results The detection rates of peripheral blood flow and internal blood flow in the malignant breast tumor group were significantly higher than those of benign breast tumor group(P<0.05).Among all the TNM stages of breast cancer,the coincidence rate between ultrasound automatic volume imaging and pathology was 58.82%,while that between contrast-enhanced ultrasound microangiography and pathology was 85.29%(P<0.05).The specificity of the combined imaging was significantly higher than that of the single contrast-enhanced ultrasound microangiography and automatic volume imaging,and the difference was statistically significant(P<0.05).Kappa was the highest in combined diagnosis,and the consistency of pathological judgment was the best.Conclusions Ultrasound automatic volume imaging and contrast-enhanced microangiography could accurately and objectively provide the angiogenesis level and structural changes of the lesion in breast cancer,which is helpful for the clinical diagnosis of breast cancer.The combined application shows the best sensitivity and consistency with the pathological results.