超声定位光散射断层成像在乳腺肿瘤诊断中的应用价值  

Value of diffusion optical tomography in the differential diagnosis of breast lesions

作　　者：王会东[1] 马腾 WANG Huidong;MA Teng(Department of Breast Surgery,Weifang People's Hospital,Weifang 261041,China)

机构地区：[1]潍坊市人民医院乳腺外科,山东潍坊261041

出　　处：《潍坊医学院学报》2018年第5期340-342,共3页Acta Academiae Medicinae Weifang

摘　　要：目的初步研究超声定位光散射断层成像(DOT)用于鉴别乳腺良、恶性肿瘤的临床可行性,并且评价其对乳腺良、恶性病变的鉴别诊断价值及对常规超声的辅助诊断价值。方法选取2016年10月～2017年8月,在潍坊市人民医院进行乳腺病变切除活检术的患者为研究对象。术前进行常规超声检查,记录各种超声征象。超声显示明确病变后,用超声辅助引导定位,乳腺光散射断层成像系统(DOT)测量病变内部血红蛋白总浓度。以外科手术的病理结果作为最终诊断的金标准。结果本研究共有乳腺病变196个,其中良性病变92个,恶性病变104个。恶性病变的血红蛋白总浓度均值明显高于良性病变(P <0. 05)。良性组(纤维腺瘤组、腺病组、导管内乳头状瘤组)病变的血红蛋白总浓度均值无显著差异(P> 0. 05),恶性组(浸润性导管癌组、导管内癌组、浸润性小叶癌组)病变的血红蛋白总浓度均值无显著差异(P> 0. 05)。DOT的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为82. 6%,65. 8%,73. 3%,76. 1%,81. 2%.常规超声的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为90. 7%,69.8%,79. 5%,85. 8%,81. 3%.另外,对于可疑恶性的乳腺病变,联合应用超声和光散射断层成像可将诊断特异性提高至78. 9%,准确性提高至81. 5%.结论乳腺良、恶性病变内部的血红蛋白总浓度存在显著差异,且恶性病变的血红蛋白总浓度明显高于良性病变。但在不同病理类型的良性组间和恶性组间,血红蛋白总浓度无显著差异。超声定位光散射断层成像用于鉴别乳腺病变具有潜在辅助诊断价值。Objective Feasibility of using US-guided diffused optical tomography( DOT) in differentiating breast malignant lesions from benign lesions and evaluate its clinical efficacy. Methods From October 2016 to August2017,patients scheduled for open biopsy at Peking Union Medical College Hospital were included. First,conventional US was performed at each patient,all the US features( including Color Doppler Flow Imaging) were recorded. Then grayscale US was used to guiding location of the breast lesion,diffused optical tomography was performed. Of each visible breast lesion detecting by US,total hemoglobin concentration( THC) was acquired from DOT. Sensitivity,specifcity and overall accuracy were determined with surgical pathology as the gold standard. Results There were 92 benign lesions and 104 malignant lesions in 196 breast lesions. THC of all lesions was acquired. The THC of malignant lesions was significantly higher than that of benign lesions( P < 0. 05). There was no significant difference of average THC in benign groups,such as fibroadenoma group,adenosis group,and intraductal papilloma group( P > 0. 05). There was no significant difference of average THC in malignant groups,such as invasive ductal carcinoma group,ductal carcinoma in situ group,and invasive lobular carcinoma group( P > 0. 05). The sensitivity,specificity,accuracy,positive predictive value,negative predictive value of DOT were 82. 6%,65. 8%,73. 3%,76. 1%,81. 2% respectively. The sensitivity,specificity,accuracy,positive predictive value,negative predictive value of conventional US were 90. 7%,69. 8%,79. 5%,85. 8%,81. 3%. Moreover,combined conventional US with DOT using for identifying breast cancer from benign lesions,the specificity could be increased to 78. 9%,and overall accuracy could be increased to 81. 5%. Conclusion There were significant difference of THC between benign and malignant groups,and the THC of malignant lesions was significantly higher than benign lesions. However,there were no significant difference of THC in inter-groups of

关 键 词：光散射断层成像 乳腺肿瘤 超声 

分 类 号：R737.9[医药卫生—肿瘤]