彩色多普勒血流成像联合超声弹性成像在乳腺癌临床诊断、新辅助化疗疗效评估中的应用价值

Application value of color Doppler flow imaging combined with ultrasound elastography in clinical diagnosis of breast cancer and evaluation of neoadjuvant chemotherapy efficacy

目的探讨彩色多普勒血流成像(CDFI)联合超声弹性成像(UE)技术在乳腺癌临床诊断、新辅助化疗疗效评估中的应用价值。方法选取124例乳腺肿块患者,所有患者均接受CDFI、UE及病理检查,其中乳腺癌患者接受新辅助化疗。以病理检查结果为金标准,分析CDFI、UE对乳腺癌的诊断价值及对乳腺癌新辅助化疗疗效的评估价值。结果病理检查结果显示,124例患者中,乳腺癌患者66例(乳腺癌病灶76个),乳腺良性肿块患者58例(良性肿块60个)。CDFI检查结果显示,良性肿块78个,恶性肿块58个;UE检查结果显示,良性肿块68个,恶性肿块68个。CDFI、UE联合检查诊断乳腺癌的灵敏度、特异度、准确度分别为92.11%、93.33%、92.65%,均高于CDFI、UE单独检查,CDFI、UE单独及联合检查诊断乳腺癌与病理检查结果的Kappa值分别为0.43、0.56、0.92。66例乳腺癌患者新辅助化疗有效54例,无效12例。CDFI、UE联合检查评估乳腺癌新辅助化疗疗效的灵敏度、特异度、准确度分别为92.59%、91.67%、92.42%,均高于CDFI、UE单独检查,CDFI、UE单独及联合检查评估乳腺癌新辅助化疗疗效与病理检查结果的Kappa值分别为0.49、0.51、0.87。结论CDFI、UE联合检查对乳腺癌的诊断效能优于单一检查,两者联合评估乳腺癌新辅助化疗疗效具有一定的可行性,值得推广。

Objective To investigate the application value of color Doppler flow imaging(CDFI)combined with ul-trasound elastography(UE)in the clinical diagnosis of breast cancer and evaluation of neoadjuvant chemotherapy effica-cy.Method A total of 124 patients with breast masses were collected.All patients received CDFI,UE,and pathological examinations,and patients with breast cancer received neoadjuvant chemotherapy.Pathological examination results were set as the gold standard,and the diagnostic value of CDFI and UE in breast cancer and the evaluation value of neoadju-vant chemotherapy efficacy for breast cancer were analyzed.Result Pathological examination results showed that among the 124 patients,66 were breast cancer patients(76 breast cancer lesions),and 58 were benign breast masses pa-tients(60 benign masses).The results of the CDFI examination showed that there were 78 benign masses and 58 malig-nant masses;UE examination results showed that there were 68 benign masses and 68 malignant masses.The sensitivity,specificity,and accuracy of combined CDFI and UE in diagnosing breast cancer were 92.11%,93.33%,and 92.65%,re-spectively,which were higher than those of CDFI and UE alone.The consistent Kappa values of CDFI or UE alone and in combination to diagnosis breast cancer and the pathological examination results were 0.43,0.56,and 0.92,respectively.Neoadjuvant chemotherapy in 66 breast cancer patients was effective in 54 cases and ineffective in 12 cases.The sensitivi-ty,specificity,and accuracy of combined CDFI and UE in evaluating the efficacy of neoadjuvant chemotherapy in breast cancer were 92.59%,91.67%,and 92.42%,respectively,which were higher than those of CDFI and UE alone.The consis-tent Kappa values of CDFI or UE alone and in combination to evaluate the efficacy of neoadjuvant chemotherapy in breast cancer and the pathological examination results were 0.49,0.51,and 0.87,respectively.Conclusion The com-bined examination of CDFI and UE is better than a single examination in the diagnosis of breast cancer,and the combined evaluation of the neoadjuvant chemotherapy efficacy in breast cancer has certain feasibility and is worthy of promotion.