常规超声、彩色多普勒超声及超声造影各指标与乳腺肿块良恶性的相关性分析  

Correlation Analysis of Conventional Ultrasound,Color Doppler Ultrasound and Contrast-enhanced Ultrasound with Benign and Malignant Breast Masses

作　　者：向彩云 徐薇[1] XIANG Caiyun;XU Wei(Jingzhou First People’s Hospital,The First Affiliated Hospital of Yangtze University,Jingzhou City,Hubei Province 434000)

机构地区：[1]长江大学附属第一医院荆州市第一人民医院,湖北省荆州市434000

出　　处：《医学理论与实践》2022年第7期1095-1098,共4页The Journal of Medical Theory and Practice

摘　　要：目的:研究乳腺肿块超声各观察指标(生长方向、钙化、边缘、形态、内部回声、后方回声;CDFI血流信号分级;增强强度、顺序、均匀性、大小变化、时相、有无增强缺损及滋养血管)与其病理良恶性的相关性。方法:选取2019年1月1日—2021年6月30日首次来我院就诊的乳腺疾病患者共139例(143个病灶),均行常规超声、彩色多普勒超声(CDFI)及超声造影(CEUS)检查,病理结果明确。分析超声各检查方法诊断乳腺肿块的敏感性、特异性及其与病理结果的符合率。采用单因素筛选出与病理良恶性有统计学意义的超声观察指标,进一步用Logistic多因素回归分析筛选出肿块超声与病理良恶性的各相关性观察指标,然后将相关指标联合与病理良恶性进行对比分析。结果:各观察指标中肿块的生长方向、钙化、边缘、形态、CDFI分级、增强均匀性及滋养血管对其良恶性的诊断具有统计学意义(P<0.05);其中肿块边缘、钙化、滋养血管与之有相关性(P<0.05)。病灶超声表现符合以下4种情况时考虑恶性的可能性大:(1)有滋养血管、边缘不清、无钙化;(2)有滋养血管、边缘不清、微钙化;(3)有滋养血管、边缘欠清、无钙化;(4)有滋养血管、边缘清、微钙化。本研究中恶性符合率分别为93.2%、100.0%、94.1%、100.0%;当病灶表现为无滋养血管、边缘清、无钙化时考虑良性的可能性大,符合率100.0%。结论:各观察指标中边缘、钙化及滋养血管对乳腺肿块良恶性的诊断有统计学意义且具有相关性;与常规超声和CDFI相比,CEUS对乳腺肿块的诊断敏感性和符合率明显提高,但特异性相对较低;联合三种超声检查方法可提高乳腺肿块良恶性的符合率。Objective:To study the ultrasonographic observation indexes of breast mass(growth direction,calcification,margin,morphology,internal echo,posterior echo;CDFI blood flow signal classification;Enhancement intensity,order,uniformity,size change,phase,whether to enhance defect and nourish blood vessel) and its pathological benign and malignant correlation.Methods:A total of 139 patients with breast diseases(143 lesions) who came to our hospital for the first time from January 1 st 2019 to June 30 th 2021 were selected and underwent conventional ultrasound,color Doppler ultrasound(CDFI) and contrast-enhanced ultrasound(CEUS) examination.The pathological results were clear.The sensitivity,specificity and coincidence rate of ultrasonography in diagnosis of breast mass were analyzed.Single factor Chi square test was used to screen out ultrasound observation indexes with statistical significance to pathological benign and malignant lesions.Logistic multifactor regression was further used to analyze the correlation between ultrasound and pathological benign and malignant lesions,and then the correlation indexes were combined with pathological benign and malignant lesions for comparative analysis.Results:The growth direction,calcification,margin,morphology,CDFI grading,enhanced homogeneity and blood vessel nourishing had statistical significance in the diagnosis of benign and malignant tumors(P<0.05).Among them,mass margin,calcification and blood vessel trophoblast were correlated with it(P<0.05).Malignant lesions are more likely to be considered when ultrasound findings are in accordance with the following four conditions:(1) trophoblast vessels,unclear margins and no calcification;(2) trophoblast vessels,unclear margins and microcalcification;(3) trophoblast vessels,unclear margins and no calcification;(4) trophoblast vessels,marginal clearness and microcalcification.In this study,the malignant coincidence rates were 93.2%,100.0%,94.1% and 100.0%,respectively.When the lesions showed no trophoblast vessels,clear margins an

关 键 词：乳腺肿块 良恶性 超声检查 CDFI CEUS 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]