乳腺超声检查征象对不典型浸润性导管癌的诊断效能  

Diagnostic efficacy of breast ultrasound signs for atypical invasive ductal carcinoma

作　　者：李静 王芳 吴国柱 冯德喜 梁丹燕 LI Jing;WANG Fang;WU Guozhu;FENG Dexi;LIANG Danyan(Department of Ultrasound,Inner Mongolia Autonomous Region People's Hospital,Hohhot 010017,China)

机构地区：[1]内蒙古自治区人民医院超声医学科,呼和浩特010017

出　　处：《山东医药》2021年第24期10-14,共5页Shandong Medical Journal

基　　金：内蒙古自治区科技计划项目(2020GG0086)。

摘　　要：目的探讨乳腺超声检查征象对不典型浸润性导管癌的诊断效能。方法手术病理诊断为浸润性导管癌结节34枚(观察组),乳腺良性肿物38枚(对照组),比较两组超声检查征象,将单因素有统计学差异的指标纳入Logistic回归模型中进行多因素分析,建立Logistic回归模型,绘制ROC曲线,评价该模型对不典型浸润性导管的诊断价值。结果单因素分析发现,两组肿物纵横比≥1、内部回声不均匀、RI>0.70、造影后肿物增强方式、后期增强程度、边界不清晰、造影剂分布不均匀、造影后肿物范围扩大、周围见滋养血管比较有统计学差异。多因素分析显示,肿物内部回声分布不均匀、RI>0.70、造影剂向心性增强、造影后肿物范围扩大为诊断不典型浸润性导管癌的危险因素。以上述危险因素建立诊断模型:Logistic(P)=-4.225+2.676(回声不均匀)+2.865(RI>0.70)+3.968(向心性增强)+3.712(范围扩大),该模型诊断不典型浸润性乳腺癌的截断值为0.436,AUC为0.965(0.892~0.994),灵敏度88.24%,特异度89.47%。结论利用肿物内部回声不均匀、RI>0.70、造影剂向心性增强、造影后肿物范围扩大4个超声征象作为变量建立诊断模型,诊断不典型浸润性导管癌准确性较高。Objective To explore the diagnostic efficacy of breast ultrasound signs for atypical invasive ductal carcinoma.Methods Through surgical pathological diagnosis,34 invasive ductal carcinoma nodules(observation group)and 38 benign breast tumors(control group) were selected.The ultrasound examination signs of the two groups were compared.The single-factor statistically different indicators were incorporated into the Logistic regression model for multivariate analysis,the Logistic regression model was established,and the ROC curve was drawn to evaluate the diagnostic value of the model for atypical invasive ductal carcinoma.Results Univariate analysis showed that significant differences were found between these two groups in the following aspects:aspect ratio≥1,uneven internal echo,RI>0.70,tumor enhancement method after contrast,late enhancement degree,unclear boundary,uneven distribution of contrast agent,range expansion,and nourishing blood vessels.Multivariate analysis showed that uneven internal echo,RI>0.70,concentricity enhancement,and range expansion were risk factors for the diagnosis of atypical invasive ductal carcinoma.We established a diagnostic model based on the above risk factors:Logistic(P)=-4.225+2.676(uneven echo)+2.865(RI>0.70)+3.968(concentricity enhancement)+3.712(range expansion).The cut-off value of this model for the diagnosis of atypical invasive ductal carcinoma was 0.436,the AUC was 0.965(0.892-0.994),the sensitivity was 88.24%,and the specificity was 89.47%,respectively.Conclusion The Logistic regression model established by the four ultrasound signs of uneven internal echo,RI> 0.70,concentricity enhancement,and range expansion has a high accuracy in diagnosing atypical invasive ductal carcinoma.

关 键 词：不典型浸润性导管癌 超声征象 灰阶图像 彩色多普勒 超声造影 

分 类 号：R320.1140[医药卫生—人体解剖和组织胚胎学]