乳腺的常规超声及超微血管成像技术对乳腺结节分级的相关性研究

tudy on the correlation between conventional ultrasonography and ultramicroangiography in the classification diagnosis of breast nodules

目的:根据临床分析比较良恶性乳腺结节的血流动力学特征情况,探讨采用乳腺超微血管成像检查技术(SMI)联合乳腺报告与数据系统(BI-RADS分级)在临床诊断BI-RADS4类乳腺结节中的应用价值。方法:收集分析2018-11~2019-11佳木斯大学附属第一医院普外科及肿瘤外科收治的乳腺BI-RADS分级为4类乳腺结节的患者,术前行超声检查记录彩色多普勒(CDFI)结节内的血流成像特点,再进行SMI检查记录结节内的血流数量及走形特点,术后参照病理结果,比较分析单独应用CDFI与BI-RADS分级和联合应用SMI与BI-RADS分级的诊断效能。结果:①通过病理结果比对与血管检测,良性组与恶性组之间在周边血流、内部血流和穿支血管三方面存在显著差异(P<0.01)。②SMI对于BI-RADS 4级结节血流显示能力优于CDFI。结论:SMI相比常规超声的彩色多普勒血流显影而言,对于血流信号的显示效果更好,更能捕捉到细小血流,联合应用SMI与BI-RADS分级能够提高乳腺结节的诊断率,为乳腺肿瘤的高频彩超及钼靶检查后的有效补充做出贡献。

Objective:To compare the hemodynamic characteristics of benign and malignant breast nodules according to clinical analysis,and to explore the application value of breast ultramicroangiography(SMI)combined with breast report and data system(BI-RADS classification)in the clinical diagnosis of BI-RADS4 type breast nodules.Methods:Patients with breast nodules classified as category 4 by BI-RADS were selected from the Department of General Surgery and the Department of Oncology,the First Affiliated Hospital of Jiamusi University from November 2018 to November 2019.Preoperative ultrasonography was performed to record the blood flow imaging characteristics in the nodule,and then SMI examination was performed to record the blood flow quantity and shape characteristics in the nodule.The diagnostic efficacy of CDFI and BI-RADS grading alone and SMI and BI-RADS grading combined were compared and analyzed according to the postoperative pathological results.Results:①There were significant differences in peripheral blood flow,internal blood flow and perforator vessels between benign group and malignant group(P<0.01).②SMI is better than CDFI in the blood flow display of BI-RADS grade 4 nodules.Conclusion:Compared with conventional ultrasound color Doppler blood flow imaging,SMI has better display effect on blood flow signal and can capture fine blood flow more effectively.The combined application of SMI and BI-RADS classification can improve the diagnostic rate of breast nodules,and is an effective supplement for high-frequency color ultrasound and molybdenum target examination of breast tumors.