超声光散射鉴别诊断乳腺良恶性肿瘤——与磁共振DWI的对比研究  

Ultrasonic diffused optical tomography in the differential diagnosis of benign and malignant breast lesions——a comparative study with diffusion weighted imaging

作　　者：吕秀花[1] 赵萍[2] 徐俊卿[1] 王虹[1] 印弘[1] 

机构地区：[1]第四军医大学附属西京医院放射诊断科,陕西西安710032 [2]第四军医大学附属唐都医院超声科,陕西西安710038

出　　处：《影像诊断与介入放射学》2016年第6期443-447,共5页Diagnostic Imaging & Interventional Radiology

基　　金：国家自然科学基金青年基金项目(No:81201136)

摘　　要：目的探讨超声光散射(DOT)鉴别乳腺良恶性肿瘤的临床应用价值,并与磁共振扩散加权成像(DWI)对比研究。方法选取85位患者,均行超声DOT及磁共振DWI检查,采集并记录定量指标最高血红蛋白浓度(MHC)及表观扩散系数(ADC),以病理结果为金标准,分别计算并比较两种成像的诊断效能。结果病理结果提示乳腺良性病变47例,恶性病变38例。ADC值:恶性组为(0.92±0.21)mm^2/s,良性组为(1.58±0.22)mm^2/s;MHC值:恶性组为(168.85±17.26)mol/L,良性组为(104.41±19.41)mol/L;MHC和ADC值在乳腺良恶性肿瘤之间差异分别具有统计学意义(P<0.05),乳腺肿块恶性组的MHC和ADC值均明显高于良性组。MHC与ADC之间均存在显著性负相关(r=-0.788,P<0.05),超声DOT和磁共振DWI的诊断敏感度、特异度、阳性预测值、阴性预测值分别为84.62%、80.43%、78.57%、86.05%;82.05%、84.78%、82.05%、84.78%;二者差异无统计学意义(P>0.05)。结论超声光散射,间接反映组织微观的生理或病理改变,在乳腺良恶性病变的鉴别诊断中均具有较好的临床应用价值,对乳腺可疑病变,可作为进一步功能学影像检查的重要补充。Objective To investigate the value of ultrasonic diffused optical tomography（DOT） in the differential diagnosis of benign and malignant breast lesions compared to diffusion-weighted imaging（DWI）. Methods 85 patients underwent ultrasonic DOT and DWI. The maximum hemoglobin concentration（MHC） and apparent diffusion coefficient（ADC） were measured. The diagnostic efficiency of the pathologically confirmed benign（47） and malignant（38） lesions was compared. Results The MHC was significantly higher in malignancy（168.85 ±17.26 mol/L） whereas the ADC of malignancy（0.92 ±0.21 mm^2/s） was significantly lower than that of benign lesions（104.41 ±19.41 mol/L, 1.58 ±0.22 mm^2/s）. The MHC correlated negatively with ADC（r =-0.788, P〈0.05）. The 84.62% sensitivity, 80.43% specificity, 78.57% positive and 86.05% negative predictive values of DOT were not significantly different from that of DWI（82.05%, 84.78%, 82.05%, 84.78%）. Conclusion Ultrasonic DOT indirectly reflects physiological and pathological information. It is valuable as a complementary functional imaging method in the differential diagnosis of benign and malignant breast lesions.

关 键 词：乳腺肿瘤 光散射成像 磁共振成像 扩散加权成像 

分 类 号：R737.9[医药卫生—肿瘤] R445[医药卫生—临床医学]