超声造影微血管成像对乳腺良恶性病变的诊断效能  

The diagnostic efficiency of contrast-enhanced ultrasound MFI for benign and malignant breast lesions

作　　者：杨爽[1] 刘宏武[2] 祝艳秋[1] 李政 林雅杰[1] YANG Shuang;LIU Hong-wu;ZHU Yan-qiu(Department of ultrasound,Affiliated Zhongshan Hospital of Dalian University,Liaoning 116001,China;不详)

机构地区：[1]大连大学附属中山医院超声科,辽宁大连116001 [2]大连大学附属中山医院麻醉科,辽宁大连116001 [3]大连大学新华临床学院,辽宁大连116622

出　　处：《中国医学装备》2023年第3期94-97,共4页China Medical Equipment

基　　金：辽宁省科学技术计划(2019-ZD-0303)“乳腺超声造影预测模型的建立及其对乳腺良恶性病变诊断效能的分析”。

摘　　要：目的:探讨超声造影微血管成像(MFI)对乳腺良恶性病变的诊断效能。方法:选取在医院住院治疗的96例(105个病灶)女性乳腺疾病患者,所有患者病理诊断前采用超声进行乳腺检查,按照Adler血流分级标准,分别观察对比同一肿物在彩色多普勒血流显像(CDFI)和MFI检出血流的差异,使用乳腺影像报告和数据系统(BI-RADS)分级诊断标准进行评价;采用受试者特征(ROC)曲线结合病理学检查分析MFI在BI-RADS评估乳腺良恶性病变中的诊断效能。结果:96例患者的105个乳腺病灶中,经病理学检查结果显示:良性病灶56个(占53.33%),恶性病灶49个(占46.67%)。MFI模式下Adler血流0级~Ⅲ级比较,差异有统计学意义(χ^(2)=8.845,P<0.05),CDFI模式下Adler血流0级~Ⅲ级比较,差异有统计学意义(χ^(2)=7.931,P<0.05);MFI模式下血流检出率和恶性肿瘤检出率明显高于CDFI,差异有统计学意义(χ^(2)=9.375,χ^(2)=4.143;P<0.05)。MFI结合BI-RADS分级诊断乳腺良恶性病变的诊断准确率为95.23%,CDFI结合BI-RADS分级诊断乳腺良恶性病变的诊断准确率为86.67%,MFI、CDFI联合BI-RADS分级ROC曲线下面积(AUC)分别为0.805和0.724,MFI诊断灵敏度、特异度及准确度明显高于CDFI。结论:MFI对于乳腺肿瘤内的微血管显示有更高的灵敏度,在判断乳腺良恶性病变中具有一定的临床应用价值。Objective:To investigate the diagnostic efficiency of contrast-enhanced ultrasound micro flow imaging(MFI)for benign and malignant breast lesions.Methods:A total of 96 female patients with breast diseases(105 breast lesions)who admitted to hospital were selected.All patients were examined by ultrasound before pathological diagnosis.According to Adler's blood flow grading standard,the differences of the measured blood flow in the same tumor between color Doppler flow imaging(CDFI)and MRI technique were observed.At the same time,the grading diagnostic standard of breast imaging report and data system(BI-RADS)was used to conduct evaluation.The pathological examination was combined to analyze the diagnostic efficiency of MFI in benign and malignant breast lesions that were assessed by BI-RADS.Results:In the 105 breast lesions of 96 patients,the results of pathological examination showed that 56 lesions were benign lesions(53.33%)and 49 lesions were malignant lesions(46.67%).There was statistically significant difference among Adler blood flow grade 0–grade III under MFI mode(χ^(2)=8.845,P<0.05),and there was statistically significant difference among Adler blood flow grad 0-grade III under CDFI mode(χ^(2)=7.931,P<0.05).The detection rates of blood flow and malignant tumor of MFI mode were significantly higher than those of CDFI(χ^(2)=9.375,χ^(2)=4.143,P<0.05),respectively.The diagnostic accuracy rate of MFI combined with BI-RADS grading was 95.23%in diagnosing benign and malignant breast lesions,and that of CDFI combined with BI-RADS grading was 86.67%.The area under curve(AUC)of MFI combined with BI-RADS grading and CDFI combined with BI-RADS grading respectively was 0.805 and 0.724.The diagnostic sensitivity,specificity and accuracy of MFI were obviously higher than these of CDFI,respectively.Conclusion:MFI has higher sensitivity for the display of microvessel within breast tumors,and it has a certain of clinical application value in judging benign and malignant breast lesions.

关 键 词：彩色多普勒血流显像(CDFI) 超声造影微血管成像(MFI) 乳腺癌 乳腺影像报告和数据系统(BI-RADS) 

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