多模态超声在乳腺髓样癌诊断中的应用价值  

Application value of multimodal ultrasound in the diagnosis of medullary breast carcinoma

作　　者：张玉静[1] 成品秀 姜月 康素玲[1] ZHANG Yu-jing;CHENG Pin-xiu;JIANG Yue;KANG Su-ling(Department of Ultrasound,Jiaozuo People's Hospital,Jiaozuo 454100,Henan,CHINA)

机构地区：[1]焦作市人民医院超声科,河南焦作454100

出　　处：《海南医学》2022年第13期1717-1720,共4页Hainan Medical Journal

摘　　要：目的 探索超声下声触诊组织成像(VTI)、声触诊组织量化(VTQ)、超声造影(CEUS)、剪切波弹性成像(SWE)等多模态超声对乳腺髓样癌的诊断价值。方法 前瞻性选取焦作市人民医院2018年1月至2020年12月期间收治的32例疑似乳腺髓样癌患者为研究对象,所有患者均进行CEUS、SWE、VTQ、VTI检查,以手术病理活检结果为金标准,分析多模态超声诊断正确率,再比较良恶性病变的各项参数值,再用受试者工作特征曲线(ROC)分析多模态超声各项定量参数的预测价值,采用Spearman法分析乳腺病变与多模态超声各参数特征的相关性。结果 32例疑似乳腺髓样癌经病理活检确诊20例,多模态超声检查准确率为95.00%(19/20);恶性病变组患者的V_(max)、V_(mean)、VTI评分、E_(min)、E_(max)、PI均高于良性病变,PT低于良性病变组,差异均具有统计学意义(P<0.05);经Spearman法分析结果显示,乳腺病变与V_(max)、V_(mean)、VTI评分、E_(min)、E_(max)、PI呈正相关(P<0.05),与PT呈负相关(P<0.05);经ROC曲线分析发现,V_(max)、V_(mean)、VTI评分、E_(min)、E_(max)、PI、PT及七项联合早期预测乳腺髓样癌的曲线下面积(AUC)分别为0.783、0.798、0.817、0.783、0.858、0.833、0.792、0.979。结论 多模态超声是一种区分效果好、准确性高的检测技术,运用于乳腺髓样癌患者中可提高正确诊断率。Objective To explore the value of multimodal ultrasound in the diagnosis of medullary breast carcinoma,such as virtual touch tissue imaging(VTI),virtual touch tissue quantification(VTQ),contrast-enhanced ultrasound(CEUS),and shear wave elastography(SWE)under ultrasound.Methods Thirty-two patients with suspected medullary breast cancer in Jiaozuo People's Hospital from January 2018 to December 2020 were prospectively selected as the research objects.All patients underwent CEUS,SWE,VTQ,and VTI.Taking the results of surgical and pathological biopsy as the gold standard,the diagnostic accuracy of multimodal ultrasound was analyzed,and then the parameters of benign and malignant lesions were compared.The predictive value of quantitative parameters of multimodal ultrasound was analyzed by receiver operating characteristic(ROC)curve,and the correlation between breast lesions and parameters of multimodal ultrasound was analyzed by Spearman method.Results Among the 32 cases of suspected medullary breast cancer,20 were confirmed by pathological biopsy,and the accuracy rate of multimodal ultrasonography was 95.00%(19/20).The scores of V_(max),V_(mean),VTI score,E_(min),E_(max),and PI in the malignant lesion group were higher than those in the benign lesion group,and the PT was lower than that of the benign lesion group,with statistically significant differences(P<0.05).The results of Spearman analysis showed that breast lesions were positively correlated with V_(max),V_(mean),VTI score,E_(min),E_(max),and PI(P<0.05),and negatively correlated with PT(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of V_(max),V_(mean),VTI score,E_(min),E_(max),PI,PT and the combination of seven items for early prediction of medullary breast carcinoma were 0.783,0.798,0.817,0.783,0.858,0.833,0.792,0.979,respectively.Conclusion Multimodal ultrasound is a detection technique with good distinguishing effect and high accuracy,which can improve the accuracy in the diagnosis of patients with medullary breast carcinoma.

关 键 词：乳腺髓样癌 多模态超声 声触诊组织量化 诊断 超声造影 剪切波弹性成像 

分 类 号：R737.9[医药卫生—肿瘤]