超声血流参数及CT参数在乳腺良恶性结节鉴别诊断中应用价值

Application Value of Ultrasonic Blood Flow Parameters and CT Parameters in Differential Diagnosis of Benign and Malignant Nodules of Breast

目的探讨超声血流参数及CT参数在乳腺良恶性结节鉴别诊断中的应用价值。方法选取2014年1月至2018年12月期间我院接收的496例乳腺结节患者,经病理诊断证实其中恶性结节148例分为恶性组,良性结节348例分为良性组,均采取CT及超声检查。统计两组超声血流检出率、超声血流参数[搏动指数(PI)、阻力指数(RI)、收缩期峰值血流速度(PSV)]、肿瘤CT形态学特性、CT参数[平均通过时间(MTT)、表面通透性(PS)、血容量(BV)、血流量(BF)]、CT及超声单独及联合鉴别乳腺结节良恶性的诊断效能。结果(1)超声血流检出率:恶性组超声血流等级0级、Ⅰ级检出率低于良性组,Ⅱ级、Ⅲ级及总检出率均高于良性组(P<0.05)。(2)超声血流参数:恶性组PI、RI、PSV值均高于良性组(P<0.05)。(3)肿瘤CT形态学特性:恶性组形态分叶率(54.73%)、边缘毛刺率(81.76%)、非均匀强化率(86.49%)均高于良性组(P<0.05)。(4)CT参数:恶性组MTT值与良性组对比无显著差异(P>0.05);但恶性组PS、BV、BF值均高于良性组(P<0.05)。(5)诊断效能:CT与超声联合诊断对乳腺恶性结节诊断敏感度(95.27%)高于CT(84.46%)及超声(86.49%)单独诊断(P<0.05)。结论超声血流参数及CT参数联合诊断能进一步明确乳腺结节患者病灶血流参数、形态学特性,显著提高乳腺良恶性结节鉴别的敏感度,可为临床鉴别乳腺良恶性结节提供更精准数据,具有较高应用价值。

Objective To investigate the application value of ultrasonic blood flow parameters and CT parameters in the differential diagnosis of benign and malignant nodules of the breast.Methods A total of 496 patients with breast nodules from our hospital from January 2014 to December 2018 were enrolled.Pathological diagnosis confirmed that 148 cases of malignant nodules were classified into malignant group,and 348 cases of benign nodules were classified into the benign group.CT and ultrasound exa mination.The two groups of ult rasonic blood flow detection rate,ultrasonic blood flow parameters[beat index(PI),resistance index(RI),peak systolic blood flow velocity(PSV)],tumor CT morphological cha ra cteristics,CT parameters[mean transit time](MTT),surface permea bility(PS),blood volume(BV),blood flow(BF)],CT and ultrasound alone and in combination to identify the benign and malignant diagnostic efficacy of breast nodules.Results(1)Ultrasound blood flow detection rate:malignant blood flow grade 0,gradeⅠdetection rate was lower than that benign group,gradeⅡ,Ⅲ and total detection rate were higher than those benign group(P<0.05).(2)Ultrasound blood flow parameters:PI,RI,and PSV values in the malignant group were higher than those in the benign group(P<0.05).(3)Morphological characteristics of tumor CT:malignant group morphology leaf rate(54.73%),edge burr rate(81.76%),non-uniform enhancement rate(86.49%)were higher than those benign group(P<0.05).(4)CT parameters:There was no significa nt difference in MTT value between the malignant and benign groups(P>0.05).However,the values of PS,BV,and BF values in the malignant group were higher than those in the benign group(P<0.05).(5)Diagnostic efficacy:The diagnostic sensitivity of CT and ultrasound combined diagnosis of malignant breast nodules(95.27%)was higher than that of CT(84.46%)and ultrasound(86.49%)alone(P<0.05).Conclusion The combined diagnosis of ultrasound blood flow parameters and CT parameters can further clarify the blood flow parameters and morphological cha racteristics of patients with breast nodules,and significantly improve the sensitivity of benign and malignant nodules of the breast.It can provide more accurate identification of benign and malignant breast nodules-date,with high application value.