常规超声联合弹性成像评估DCIS与病理分级相关性研究  

Correlation Between Ultrasound Combined with Elastography Evaluating DCIS and Pathological Grading

作　　者：宋建明 曾小玉 游宇光 李伟松 叶军 曾琪 曾晓英 Song Jianming;Zeng Xiaoyu;You Yuguang;Li Weisong;Ye Jun;Zeng Qi;Zeng Xiaoying(Department of Ultrasound Medicine,First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000,China;Department of Pathology,First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi 341000,China)

机构地区：[1]赣南医科大学第一附属医院超声医学科,江西省赣州市341000 [2]赣南医科大学第一附属医院病理科,江西省赣州市341000

出　　处：《中国超声医学杂志》2024年第5期507-511,共5页Chinese Journal of Ultrasound in Medicine

基　　金：江西省赣州市卫生健康委科研计划项目(No.2022-2-059)。

摘　　要：目的探讨常规超声(US)联合超声弹性成像(UE)在乳腺导管原位癌(DCIS)诊断中的价值及与病理分级的相关性。方法选取行乳腺超声检查185例患者共208个病灶,以术后病理结果为金标准,DCIS组病灶136个,良性组病灶72个;回顾性分析DCIS病灶的二维及彩色多普勒血流成像(CDFI)表现、UE及其与病理分级的关系,分别计算US、UE以及两者联合诊断的灵敏度、特异度、准确度,构建受试者工作特征(ROC)曲线,分析3种方法对病灶的诊断价值。结果US联合UE对乳腺病灶诊断的灵敏度、特异度、准确度、阴性预测值、阳性预测值分别为93.38%、90.28%、92.31%、87.84%、94.78%,其曲线下面积(AUC)为0.918±0.024,优于单一诊断法,差异有统计学意义(P<0.05)。DCIS病灶US主要表现为肿块型(63.98%)、导管改变(69.85%)、回声不均匀(74.26%)、伴微钙化(71.32%)、血流信号Adler≥Ⅱ级(70.59%);弹性评分≥4分(84.56%)。结论随着病理级别增高DCIS恶性US征象愈明显,弹性评分亦增高,US联合UE对DCIS具有良好的诊断价值。Objective Exploring the value of ultrasound(US)combined with ultrasound elastography(UE)to evaluate ductal carcinoma in situ of the breast(DCIS)and its correlation with pathological grading.Methods A total of 185 patients who underwent breast ultrasound examination were selected,with a total of 208 lesions.Based on postoperative pathological results as the gold standard,136 lesions were the DCIS group and 72 lesions were the benign group;Weretrospectively analyzed the two-dimensional and color Doppler flow imaging(CDFI)manifestations,UE,and their relationship with pathological grading of DCIS lesions.Wecalculated the sensitivity,specificity,and accuracy of US,UE and their combination for the diagnosis of lesions,and constructed receiver operating characteristic(ROC)curve analysis to evaluate the diagnostic value of these three methods for lesions.Results The sensitivity,specificity,accuracy,negative predictive value,and positive predictive value of the combination of US and UE for the diagnosis of breast lesions were 93.38%,90.28%,92.31%,87.84%,and 94.78%,respectively.The area under the curve(AUC)was 0.918±0.024,which was better than the single diagnostic method,and the difference was statistically significant(P<0.05).The main manifestations of DCIS lesions were mass type(63.98%),ductal changes(69.85%),uneven echo(74.26%),accompanied by microcalcification(71.32%),and blood flow signal Adler≥grade Ⅱ(70.59%);elastic score≥4 points(84.56%).Conclusions As the pathological grade of DCIS increases,the malignant US signs become more obvious,and the elastic score also increases.The combination of US and UE has good diagnostic value for DCIS.

关 键 词：乳腺导管原位癌 超声 弹性成像 病理学分级 

分 类 号：R73[医药卫生—肿瘤]