彩色多普勒超声联合超声弹性成像及超声高精细血流成像技术对小乳癌的诊断价值分析

Analysis of diagnostic value of small breast cancer by color Doppler ultrasound combined with ultrasound elastography and ultrasound fine flow imaging

目的探讨彩色多普勒超声(CDU)联合超声弹性成像(UE)、超声高精细血流成像技术(Fine-Flow)对小乳癌的诊断价值。方法选择2017年5月至2022年5月在河北北方学院附属第二医院诊治的180例疑似小乳癌患者。按照随机数字表法分成对照组与观察组,每组90例。对照组采用常规二维超声联合CDU检查,观察组采用CDU联合UE、Fine-Flow检查,统计术后病理结果,比较2组的乳腺结节检出率、误诊率、漏诊率。以术后病理结果为金标准,比较2组诊断的敏感度、特异度、阳性预测值、阴性预测值。结果对照组恶性乳腺结节77例、良性乳腺结节13例;观察组恶性乳腺结节75例,良性乳腺结节15例。观察组的乳腺结节检出率高于对照组、误诊率低于对照组,差异均有统计学意义(均P<0.05);观察组的乳腺结节漏诊率与对照组差异无统计学意义(P>0.05)。观察组的敏感度、阴性预测值均高于对照组[96.0%(72/75)比87.0%(67/77)、81.2%(13/16)比47.4%(9/19)],差异均有统计学意义(均P<0.05);观察组和对照组特异度、阳性预测值比较差异均无统计学意义[86.7%(13/15)比69.2%(9/13)、97.3%(72/74)比94.4%(67/71)](均P>0.05)。结论CDU联合UE及Fine-Flow对小乳癌的诊断价值较高,可为临床提供可靠的参考依据。

Objective To explore the diagnostic value of color Doppler ultrasound(CDU)combined with ultrasound elastography(UE)and ultrasound fine flow imaging(Fine-Flow)in small breast cancer.Methods A total of 180 patients with suspected small breast cancer diagnosed and treated in the Second Affiliated Hospital of Hebei North University from May 2017 to May 2022 were selected.They were divided into control group and observation group according to the random number table method,with 90 cases in each group.The control group was examined by conventional two-dimensional ultrasound combined with CDU,and the observation group was examined by CDU combined with UE and Fine-Flow.The postoperative pathological results were counted,and the detection rate,misdiagnosis rate and missed diagnosis rate of breast nodules were compared between the two groups.The sensitivity,specificity,positive predictive value and negative predictive value of the two groups were compared with the postoperative pathological results as the gold standard.Results There were 77 cases of malignant breast nodules and 13 cases of benign breast nodules in the control group.There were 75 cases of malignant breast nodules and 15 cases of benign breast nodules in the observation group.The detection rate of breast nodules in the observation group was higher than that in the control group,and the misdiagnosis rate was lower than that in the control group,with statistical significance(all P<0.05);there was no statistically significant difference in the missed diagnosis rate of breast nodules between the observation group and the control group(P>0.05).The sensitivity and negative predictive value of the observation group were higher than those of the control group[96.0%(72/75)vs 87.0%(67/77),81.2%(13/16)vs 47.4%(9/19)],and the differences were statistically significant(all P<0.05);there were no statistically significant differences in specificity and positive predictive value between the observation group and the control group[86.7%(13/15)vs 69.2%(9/13),97.3%(72/74)vs 94.4%(67/71)](all P>0.05).Conclusion CDU combined with UE and Fine-Flow has relatively high value in diagnosis of small breast cancer,which can provide reliable reference for clinical practice.