三维能量多普勒超声在老年乳腺癌患者诊断中的应用  

Application of 3I）-power Doppler ultrasound in diagnosis of breast carcinoma in elderly patients

作　　者：马娜[1] 孙长坤[1] 王翠萍[1] 郭发金[1] 

机构地区：[1]卫生部北京医院超声科,100730

出　　处：《中华老年医学杂志》2014年第6期638-642,共5页Chinese Journal of Geriatrics

摘　　要：目的探讨三维能量多普勒超声在老年女性乳腺肿瘤诊断中的价值。方法回顾性分析45例老年乳腺肿瘤患者共53个病灶，根据术后病理结果分为良性组和恶性组。术前应用三维能量多普勒容积探头自动采集肿物横断面、矢状面及冠状面图像，采用虚拟器官计算机辅助分析软件重建肿物立体图像，以超声断层成像逐层、多切面观察内部及周边血流分布特征，将血流分布特征分为穿人型、中央型、环绕型、少血流型。应用三维能量多普勒直方图定量分析肿物内部的血管形成血流指数。结果良性组15个（28．3％）病灶，恶性组38个（71．7%）病灶的三维能量多普勒血流分布类型差异有统计学意义（X^2=19．52，P〈0．01）。恶性肿瘤中68．4％（26个）为穿入型血流分布，以穿入型血流诊断恶性肿瘤的敏感性68．4％，特异性86．7％，而良性肿瘤以环绕型血流分布为主（53．3％，8个）。恶性组血管形成血流指数为I．32±1．58，高于良性组0．63±0．53，差异有统计学意义（t=2．187，P〈0．05）。结论三维能量多普勒超声能够完整显示乳腺肿物立体血管分布特征、定量分析肿物血流灌注，有助于提高常规超声对乳腺良恶性肿瘤鉴别诊断能力。Objective To explore the diagnosis value of 3D-power Doppler ultrasound in differentiating benign and malignant breast masses in elderly patients. Methods A retrospective study of 53 lesions in 45 patients was performed, and breast masses were divided into benign and malignant group by pathological diagnosis after operation. Display of cross, vertical and coronal plane of total 53 masses were automatically acquired by 3D-power Doppler examination before operation, and 3D imaging of masses were reconstructed by virtual organ computer-aided analysis. The vascular morphology inside and beside the breast neoplasm was observed by tomographic ultrasound imagine layer by layer in different sections. Vascular distribution characteristics were divided into penetrating, central, surrounding and few vessel type. Quantitative analysis of vascularization-flow index inside the breast neoplasm was measured by 3D-power Doppler histogram. Results The difference in vascular distribution characteristics by 3D-power Doppler ultrasound was statistically significant between 15 （28.3%） benign and 38 （71.7%） malignant lesions（X^2= 19.52, P〈0.01）. The case number of presence of penetrating vessels was 26（68.4%）in the malignantuniors. The sensitivity and specificity of penetrating vessel diagnosed malignant breast tumor were 68.4% and 86.7 %. Vascular distribution characteristics of benign masses was mainly of surrounding vessel type（53.3%）. Vascularization-flow index was higher in malignant group than in benign group [（1.32±1.58） vs. （0.63±0.53）, t= 2. 187, P〈0.05]. Conclusions 3D-power Doppler ultrasound completely presents the vessel stereoscopical distribution and shows quantifieationally blood perfusion of breast neoplasm. The 3D- power Doppler ultrasound is superior to conventional ultrasound for enhancing differential diagnosis ability between benign and malignant breast tumors.

关 键 词：超声检查 成像 三维 乳腺肿瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]