自动乳腺全容积超声成像技术在乳腺癌诊断中的应用价值

Application Value of Automatic Full Volume Ultrasound Imaging in Breast Cancer Diagnosis

目的探究自动乳腺全容积超声成像技术在乳腺癌诊断中的应用价值。方法采用回顾性分析,研究对象选取为2017年4月至2021年3月睢县中医院的146名乳腺肿块患者,按照患者的手术病理诊断结果,将患者分为恶性组60例和良性组86例,两组患者均接受常规超声和自动乳腺全容积超声成像检查,对比两组患者的常规超声和自动乳腺全容积超声成像检查结果的差异性,并对比常规超声和自动乳腺全容积超声成像在诊断乳腺癌上的敏感性和特异性。结果病理检验结果显示,良性组患者包括乳腺腺病20例,炎性病变20例,乳腺纤维瘤38例,乳头状瘤8例;恶性组患者包括浸润性导管癌34例,浸润性小叶癌10例,导管内癌8例,浸润性小管癌8例。常规超声检查结果显示,恶性组患者超声表现(微小钙化、肿块影、腺体致密、边缘毛刺)比例与良性组比较差异有统计学意义(P<0.05)。自动乳腺全容积超声成像检查显示,恶性组患者星芒征表现比例显著低于良性组,但汇聚征和虫蚀征的表现比例显著高于良性组,差异有统计学意义(P<0.05)。常规超声与自动乳腺全容积超声成像对病灶特征参数描述的一致性分析结果为在时钟位置(α=0.679)、距皮肤距离(α=0.773)、上下径(α=0.712)、左右径(α=0.615)、纵横比(κ=0.611)和边界(κ=0.723)方面一致性强,在前后径(α=0.523)和外形(κ=0.552)方面一致性中等、而距乳头距离(α=0.289)、内部回声(κ=0.394)和后方回声特征(κ=0.236)方面一致性弱。自动乳腺全容积超声成像检查的准确度、敏感性和特异性均为100.00%,且阳性预测值、阴性预测值也均为100.00%。常规超声检查的准确率、敏感性和特异性分别为90.41%(132/146)、85.00%(51/60)和94.19%(81/86)。二者诊断表现具有较强的一致性(κ=0.943,P<0.05),自动乳腺全容积超声成像检查的准确度(χ2=14.705,P<0.05)和特异性(χ2=9.730,P<0.05)均高于常规超声检查。结论自动乳腺全容积超声成像技术用于乳腺癌的诊断价值较高,相较于常规超声具有更好的准确度和特异性,值得临床应用。

Objective To explore the application value of automatic full volume ultrasound imaging in breast cancer diagnosis.Methods By retrospective analysis,a total of 146 patients with breast mass were selected from Suixian Traditional Chinese Medicine Hospital between the April 2017 to March 2021.According to the results of surgical pathological diagnosis,the patients were divided into a malignant group of 60 cases and a benign group of 86 cases.Both groups received routine ultrasound and automatic full-volume ultrasound imaging.The results of conventional ultrasound and automatic total volume ultrasound were compared between the two groups,and the sensitivity and specificity of conventional ultrasound and automatic total volume ultrasound in the diagnosis of breast cancer were compared.Results Pathological examination results showed that the benign group included 20 cases of breast adenopathy,20 cases of inflammatory lesions,38 cases of breast fibroma,8 cases of papilloma,and the malignant group included 34 cases of invasive ductal carcinoma,10 cases of invasive lobular carcinoma,8 cases of intraductal carcinoma and 8 cases of invasive tubule carcinoma.The results of routine ultrasound examination showed that there were statistical differences between the malignant group and the benign group in the proportion of micro-calcification,mass shadow,gland dense,marginal burr and other ultrasonic manifestations,with significant differenes(P<0.05).Automatic full volume ultrasound examination of breast imaging showed that the proportion of astragalus sign in malignant group was significantly lower than that in benign group,but the proportion of convergence sign and insect corrosion sign was significantly higher than that in benign group,with statistical differences(P<0.05).The consistency analysis between conventional ultrasound and automatic full-volume ultrasound imaging in the characterization of focal characteristic parameters showed strong consistency in clock position(α=0.679),distance from skin(α=0.773),upper and lower diameter(α=0.712),left and right diameter(α=0.615),aspect ratio(κ=0.611)and boundary(κ=0.723),medium consistency in anterior and posterior diameter(α=0.523)and shape(κ=0.552),while weak consistency in nipple distance(α=0.289),internal echo(κ=0.394),and posterior echo feature(κ=0.236).The accuracy,sensitivity and specificity of automatic full-volume ultrasound were all 100.00%,and the positive predictive value and negative predictive value were also 100.00%.The accuracy,sensitivity and specificity of routine ultrasound were 90.41%(132/146),85.00%(51/60)and 94.19%(81/86),respectively.There was a strong concordance(κ=0.943,P<0.05)between the two diagnostic manifestations.The accuracy(χ2=14.705,P<0.05)and specificity(χ2=9.730,P<0.05)of automatic full volume ultrasound were higher than those of conventional ultrasound.Conclusion Automatic fullvolume ultrasound is of high diagnostic value for breast cancer.Compared with conventional ultrasound,it has better accuracy and specificity,and is worthy of application.