彩色多普勒超声与超声造影在乳腺肿瘤鉴别诊断中的价值研究  

Study on the values of color Doppler ultrasound and contrast-enhanced ultrasound in differential diagnosis of breast tumors

作　　者：谢佳佳 陈晓琼[1] 王琳玲[1] XIE Jia-jia;CHEN Xiao-qiong;WANG Lin-ling(Department of Ultrasound Imaging,The First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;不详)

机构地区：[1]湖南中医药大学第一附属医院超声影像科,湖南长沙410007

出　　处：《中国医学装备》2023年第7期81-84,共4页China Medical Equipment

基　　金：湖南省卫生健康委科研计划(202109021496)“基于AI的超声技术在乳腺肿瘤早期筛查与良恶性鉴别诊断中的研究”。

摘　　要：目的:探讨彩色多普勒超声与超声造影在乳腺肿瘤鉴别诊断中的价值。方法:选取医院就诊的116例女性乳腺肿瘤患者,以手术病理结果为“金标准”,将其分为恶性组(40例)和良性组(76例)。所有患者均行彩色多普勒超声与超声造影检查,判断两种检查方法的诊断效能,分析良性肿瘤与恶性肿瘤的形态结构与血流特点等。结果:术后病理检查结果显示,116例乳腺肿瘤患者中76例(占65.52%)为良性肿瘤,40例(占34.48%)为恶性肿瘤;彩色多普勒超声诊断10例为良性肿瘤,30例为恶性肿瘤;超声造影诊断2例为良性肿瘤,38例为恶性肿瘤。超声造影检测的灵敏度、特异度及准确率高于彩色多普勒超声,差异有统计学意义(x^(2)=6.275,x^(2)=15.833,x^(2)=21.984;P<0.05)。恶性组患者肿瘤的形态不规则、边界不清晰、回声不均匀、局部充盈缺损以及钙化例数较良性组患者明显增多,两组肿瘤形态、边界、回声、局部充盈缺损及钙化比较差异有统计学意义(x^(2)=39.490,x^(2)=54.017,x^(2)=61.857,x^(2)=42.012,x^(2)=57.452;P<0.05)。恶性组患者肿瘤的超声造影灌注强度高于良性肿瘤,峰值时间和始增时间短于良性组,差异有统计学意义(t=28.122,t=14.546,t=16.115;P<0.05);恶性组患者病灶处彩色多普勒超声中收缩期峰值血流速度(PSV)、阻力指数(RI)明显高于良性组,差异有统计学意义(t=7.211,t=10.823;P<0.05)。结论:超声造影技术在鉴别诊断乳腺良恶性肿瘤时,有着较高的诊断价值,可通过与造影剂的配合,对病灶处血流状态、血流动力学进行诊断,明显提高了诊断的准确率。Objective:To analyze the values of color Doppler ultrasound and contrast-enhanced ultrasound in the differential diagnosis of breast tumors.Methods:A total of 116 female patients with breast tumor who admitted to hospital were selected,and they were divided into the malignant group(40 cases)and the benign group(76 cases)according to the surgically pathological results as the"gold standard".All patients were examined by color Doppler ultrasound and contrast-enhanced ultrasound,and the diagnostic efficacy of the two methods were judged.And then,the morphological structure and blood flow characteristics of benign tumor and malignant tumor were analyzed.Results:The results of postoperative pathological examination showed that 76 cases(65.52%)of 116 patients with breast tumors were benign tumor and 40 cases(34.48%)of them were malignant tumors.The diagnosis of color Doppler ultrasound confirmed 10 cases as benign tumor,and 30 cases as malignant tumor.The diagnosis of contrastenhanced ultrasound confirmed 2 cases as benign tumor and 38 cases as malignant tumor.The sensitivity,specificity and accuracy of contrast-enhanced ultrasound detection were significantly higher than those of color Doppler ultrasound,and the differences of those indicators between them were statistically significant(x^(2)=6.275,x^(2)=15.833,x^(2)=21.984,P<0.05),respectively.Compared with the benign group,the number of cases of the irregular morphology,unclear boundary,uneven echo,local filling defect and calcification of the tumor in the malignant group significantly increased,and there were statistically significant differences in tumor morphology,boundary,echo,local filling defect and calcification between the two groups(x^(2)=39.490,x^(2)=54.017,x^(2)=61.857,x^(2)=42.012,x^(2)=57.452,P<0.05),respectively.The perfusion intensity of tumor in the malignant group was significantly higher than that in the benign group,and the peak value time and starting increase time of the former were significantly shorter than those in the benign group(t=28.122,t

关 键 词：超声造影 彩色多普勒超声 乳腺肿瘤 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]