多模态超声鉴别诊断皮肤肿瘤良恶性病变  

Multimodal Ultrasound in the Differential Diagnosis of Benign and Malignant Skin Tumors

作　　者：李娅荣[1] 姜凡[1] 彭梅[1] Li Yarong;Jiang Fan;Peng Mei(Department of Ultrasound Diagnosis,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院超声医学科,合肥市230601

出　　处：《中国超声医学杂志》2024年第10期1152-1156,共5页Chinese Journal of Ultrasound in Medicine

基　　金：安徽医科大学校科研基金(No.2021xkj043)。

摘　　要：目的讨论超声的3种模态对皮肤肿瘤良恶性病变的诊断价值。方法纳入经手术病理证实的112例皮肤肿瘤患者作为研究对象(良性组58例和恶性组54例),术前均行二维灰阶超声、微血管成像和弹性成像检查,记录临床特征。应用单因素分析比较良恶性组的特征差异。基于Logistic回归模型及受试者工作特征曲线分析,对三模态及其联合诊断效能进行评价与比较。结果单因素分析显示年龄、最大径、形态、边缘、微血流成像评级与弹性成像评分在皮肤肿瘤良恶性组的差异具有统计学意义(P<0.05)。Logistic回归分析与受试者工作特征曲线分析显示三模态联合(含年龄)的诊断效能最高,曲线下面积为0.951,灵敏度为88.90%,特异度为91.38%,准确度为89.29%,约登指数为0.803。各模态与组合的能效关系为:二维灰阶超声+微血流成像+弹性成像(含年龄)>二维灰阶超声+微血流成像+弹性成像>二维灰阶超声>弹性成像>微血流成像。结论超声模式下二维灰阶超声、微血流成像及弹性成像三模态联合起来对皮肤肿瘤良恶性鉴别具有较好的诊断价值。Objective To evaluate the differential diagnostic value of three modes of ultra-high frequency ultrasonography(UHFUS)for benign and malignant lesions of skin tumors.Methods A retrospective analysis was conducted on 112 patients with skin tumors(58 in the benign group and 54 in the malignant group).All patients underwent two-dimensional gray-scale ultrasound,superb microvascular imaging(SMI)and ultrasound elastography(UE)in UHFUS mode before operation,and their clinical features were recorded.Univariate analysis was used to assess the characteristics of benign and malignant groups.Based on Logistic regression model and ROC curve analysis,the energy efficiency of three modes and their joint diagnosis value were evaluated and compared.Results Univariate analysis showed that there was significant difference in age,maximum diameter,shape,margin,rating of SMI and score of UE between benign and malignant skin tumors(P<0.05).Logistic regression analysis and ROC curve analysis showed that the diagnostic efficiency of three modes combination(including age)was the highest,with AUC of 0.951;The sensitivity was 88.90%;The specificity was 91.38%;The accuracy rate was 89.29%;The Youden index was 0.803.The relationship between the efficiency of each modality and each combination was:two-dimensional gray-scale ultrasound+SMI+UE(including age)>two-dimensional gray-scale ultrasound+SMI+UE>two-dimensional gray-scale ultrasound>UE>SMI.Conclusions The combination of two-dimensional gray-scale ultrasound,SMI and UE in UHFUS mode has good diagnostic value for the differentiation of benign and malignant skin tumors.

关 键 词：皮肤肿瘤 超声多模态 LOGISTIC回归分析 ROC曲线 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.5[医药卫生—诊断学]