彩色多普勒血流成像聯(lián)合彈性成像多參數(shù)分析在乳腺腫塊鑒別診斷中的價值

摘要：目的 探討常規(guī)多普勒超聲（CDFI）聯(lián)合超聲彈性成像（UE）多參數(shù)分析在乳腺良惡性腫塊鑒別診斷中的價值。方法 回顧性分析2015年1月～12月85例患者的92個乳腺腫塊的CDFI表現(xiàn)及UE多參數(shù)分析，以術(shù)后病理結(jié)果作為金標(biāo)準(zhǔn)，對CDFI、UE及兩者聯(lián)合診斷對乳腺腫塊的鑒別價值采用SPSS18.0 統(tǒng)計(jì)軟件進(jìn)行分析，率的比較采用χ2檢驗(yàn)，P<0.05 為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果 CDFI結(jié)果與病理結(jié)果相符67個病灶，其診斷敏感性、特異性、準(zhǔn)確率分別為：70.0%（16/23），73.9%（51/69），71.7%（67/92）。UE多參數(shù)綜合診斷結(jié)果與病理結(jié)果相符71個病灶，其診斷敏感性、特異性及準(zhǔn)確性分別為73.9%（17/23），78.4%（54/69），77.2%（71/92）。CDFI與UE聯(lián)合診斷敏感性、特異性、準(zhǔn)確率分別為：86.9%（20/23），89.9%（62/69），89.1%（82/92）。以上三種診斷方法對乳腺腫塊的診斷準(zhǔn)確率比較，聯(lián)合應(yīng)用常規(guī)超聲與彈性成像技術(shù)能明顯提高診斷敏感性，特異性及準(zhǔn)確率（P<0.05）。結(jié)論 CDFI聯(lián)合UE多參數(shù)分析可提高乳腺腫塊診斷準(zhǔn)確率。

關(guān)鍵詞：乳腺腫塊；彩色多普勒血流顯像；彈性成像技術(shù)；聯(lián)合診斷

Abstract：Objective To study the value of the combination of color doppler ultrasound and elastography multiparameter in the diagnosis of breast tumor. Methods Clinical characteristics of 92 nodules in 85 patients were examined by color doppler ultrasound and elastography， with postoperative pathology results as \"gold standard\". Comparison was made between the diagnosis of the ultrasound and pathology results by using SPASS 18.0 software to evaluate clinical value of combined application of doppler ultrasound and elastography in the differential diagnosis of breast nodules. The test was used in the ratio comparison， and P<0.05 was considered statistically significant. Results The diagnostic results of 67 nodules using CDFI were in accordance with the athological results. The sensitivity， specificity，and accuracy of CDFI in detecting breast nodules were 70.0%，73.9%，and 71.7% respectively. 71 nodules using UE were in accordance with the athological results. The sensitivity， specificity，and accuracy of CDFI in detecting breast nodules were 73.9%，78.4%，and 77.2% respectively. Those of combination of CDFI and UE were 86.9%，89.9%，and 89.1% respectively. There wsa significant difference between three diagnostic performances in the differential diagnosis of benign and malignant breast nodules（P<0.05）. Conclusion The combination of CDFI and UE could improve the diagnostic accuracy of breast nodules.

Key words：Breast tumor；Color doppler flow imaging；Elastography；Combined diagnosis

乳腺癌發(fā)病率位于女性惡性腫瘤的首位，嚴(yán)重威脅女性的身心健康。早期診斷乳腺癌可以對臨床治療方案的選擇起到關(guān)鍵的作用，對乳腺癌預(yù)后極為重要。高頻彩超因無創(chuàng)價廉便捷成為乳腺檢查的首選方法，彩色多普勒超聲血流顯像（color doppler flow imaging，CDFI）從血供方面為乳腺良、惡性病灶鑒別診斷提供幫助，但有時鑒別診斷比較困難[1]。超聲彈性成像（ultrasonic elastography， UE）是從病灶質(zhì)地反映病灶性質(zhì)的一種新技術(shù)[2]。本研究旨在探討UE多參數(shù)分析（彈性成像評分、面積比值、應(yīng)變率比值）聯(lián)合CDFI在提高乳腺癌診斷準(zhǔn)確率中的價值。……