彩色多普勒能量图联合超微血管成像技术对乳腺肿块的诊断价值

Diagnostic value of color Doppler energy imaging combined with ultrastructural angiography in breast masses

目的评价彩色多普勒能量图(CDE)及超微血管成像技术(SMI)联合应用对BI-RADS+4类乳腺病灶的诊断价值。方法选取我院经病理证实的BI-RADS 4级及以上分类的乳腺良恶性病灶132例,其中良性病灶67个,恶性病灶65个。按照Adler分级标准,所有的病灶都采用CDE和SMI技术进行检测,观察同一病灶的血流分布情况,计算出两种检测技术检出血管条数的差值;CDE、SMI、CDE-SMI诊断恶性病灶的血管条数的阈值。结果两种检测方法对所有病灶血流的检测差异有统计学意义(P<0.05);对恶性病灶血流程度的检测有统计学意义(P<0.01);而对良性病灶血流程度检测无统计学意义(P>0.05)。CDE诊断恶性病灶的阈值为血管条数的≥2,敏感度90%,特异度58%;SMI诊断恶性病灶的阈值为血管条数≥3,敏感度95%,特异度71%;CDE-SMI诊断恶性病灶的阈值为≥3,敏感度97%,特异度81%。结论CDE与SMI技术都可检测乳腺恶性病灶的微血管,而SMI技术对潜在的超微血管更敏感,二者联合可为临床鉴别乳腺的良恶性病灶提供可靠的依据。

Objective To evaluate the diagnostic value of the combinationof color Doppler energy(CDE)and ultramicro-angiography(SMI)in BI-RADS+4 breast lesions.Methods A total of 132 benign and malignant breast lesions,including 67 benign lesions and 65 malignant lesions,were collected from patients with BI-RADS grade 4 or above confirmed by pathology in our hospital.According to Adler grading criteria,all lesions were detected by CDE and SMI techniques,and the blood flow distribution of the same lesion was observed,and the difference of the number of vascular strips detected by the two detection techniques was calculated;the thresholds of the number of vascular strips for the diagnosis of malignant lesions by CDE,SMI and CDE-SMI were calculated.Results There was significant difference between the two methods in detecting blood flow in all lesions(P<0.05),in detecting blood flow in malignant lesions(P<0.01),and in detecting blood flow in benign lesions(P>0.05).The threshold of CDE for the diagnosis of malignant lesions was 2 with 90%of sensitivity and 58%of specificity;the threshold of SMI for the diagnosis of malignant lesions was 3 with 95%of sensitivity and 71%of specificity;the threshold of CDE-SMI for the diagnosis of malignant lesions was 3 with 97%of sensitivity and 81%of specificity.Conclusion Both CDE and SMI techniques can detect microvessels in breast malignant lesions,while SMI technology is more sensitive to potential ultravessels,and the combination of the two techniques can provide a reliable basis for clinical identification of breast benign and malignant lesions.