超声光散射成像对乳腺肿块的诊断价值及影响因素  

Diagnostic Value of Ultrasound-Guided Diffuse Optical Imaging on Breast Cancer and its Influencing Factors

作　　者：赵天慧[1] 张炽敏[2] 李嘉[2] 

机构地区：[1]东南大学附属第二医院超声诊断科,南京市210003 [2]东南大学附属中大医院超声诊断科

出　　处：《中国超声医学杂志》2011年第7期604-608,共5页Chinese Journal of Ultrasound in Medicine

基　　金：江苏省卫生厅资助课题(No.H200756)

摘　　要：目的评价超声光散射系统对乳腺肿瘤诊断的价值并分析其影响因素。方法收集乳腺肿瘤患者84例(共88个肿块),术前行超声光散射成像,并测量乳腺肿块的大小和深度。以病理结果作为标准,计算超声光散射系统诊断乳腺恶性肿瘤的灵敏度、特异度等指标,并分析漏诊和误诊的原因。结果超声光散射成像诊断乳腺恶性肿瘤的灵敏度和特异度分别为86.1%和78.8%,阳性预报值和阴性预报值分别为73.8%和89.1%;乳腺浸润性导管癌的最大血红蛋白浓度值(210±99)μmol/L显著大于腺病(114±90)μmol/L和纤维腺瘤(78±40)μmol/L,P<0.05;漏诊和误诊与乳腺肿块的病理类型、大小或深度有关,超声可纠正80%(4/5)的漏诊和64%(7/11)误诊。结论超声光散射系统对常见的乳腺肿块有较好的定性诊断价值,乳腺肿块的病理类型、大小和深度影响诊断的准确性,结合超声声像图观察可降低漏诊率和误诊率。Objective To evaluate the diagnostic value of Ultrasound-Guided Diffuse Optical Imaging on breast tumor and analyze its influencing factors. Methods 84 consecutive women with 88 breast masses were scanned by Ultrasound-Guided Diffuse Optical Imaging before operation, the diameters and depths of breast masses were measured simultaneously. The sensitivity, specificity, positive predictive value, and negative predictive value of Ultrasound- Guided Diffuse Optical Imaging on breast cancer were calculated based on histology standard. The reasons of misdiagnosis and missed diagnosis were analyzed. Results The sensitivity, specificity, positive predictive value and negative predictive value of Ultrasound-Guided Diffuse Optical Imaging on breast cancer was 86.1% 78.8%, 73.8% and 89.1%, respectively. The average maximum hemoglobin concentration of invasive ductal carcinoma（210 ±99）μmol/h was higher than that of mammary adenosis（114 ±90） μmol/L or breast fibroadenoma（78 ±40） μmol/L, P〈0.05. The misdiagnosis and missed diagnosis of Ultrasound Guided Diffuse Optical Imaging were related to the pathological type, the size and the depth of breast mass. 80% （4/5） of the missed diagnosis and 64 % （7/11） of the misdiagnosis could be avoided by analyzing the uItrasonogram of breast masses. Conclusions Ultrasound-Guided Diffuse Optical Imaging is of great value in qualitative diagnosis of common breast mass. The pathological type, the size or the depth of breast mass may have effect on the diagnosis accuracy of Ultrasound-Guided Diffuse Optical Imaging. The rate of missed diagnosis or misdiagnosis could be reduced by analyzing the uhrasonogram of breast masses.

关 键 词：超声光散射成像 乳腺肿瘤 灵敏度 特异度 

分 类 号：R737.9[医药卫生—肿瘤]