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联合应用超声弹性成像及彩色多普勒在诊断乳腺癌及评价TNM分期中的价值 被引量:38

Evaluation of the Combined Use of Ultrasound Elastography and Color Doppler in the Diagnosis and TNM Classification of Breast Cancer
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摘要 目的联合应用超声弹性成像及多普勒技术,对乳腺肿块进行良、恶性鉴别诊断,并评价乳腺癌TNM分期。方法对58例乳腺肿块进行超声弹性成像和彩色多普勒成像检查,以术后病理结果作为金标准,使用ROC曲线比较直径变化率、最大截面积比、弹性系数评分及彩色多普勒血流评分等超声成像指标诊断乳腺癌的能力。结果与长、短径变化率相比,最大截面积比对鉴别诊断良、恶性乳腺肿块方面的诊断效能较高(曲线下面积为0.914),联合使用最大截面积比、弹性系数评分和多普勒血流评分行鉴别诊断时诊断效能最高(曲线下面积为0.981)。进展期(Ⅱ~Ⅳ期)各种弹性成像指标(长径变化率、短径变化率、最大截面积比)高于早期(0~Ⅰ期)。随TNM分期增高,弹性系数评分和多普勒血流评分分值增高。结论超声弹性成像的最大截面积比对鉴别诊断良、恶性乳腺肿块的诊断效能较高,其与彩色多普勒二者联合能够有助于提高乳腺癌确诊率,对评价乳腺癌的TNM分期有一定提示作用。 Objective To investigate the effect of the combined use of ultrasound (US) elastography and color Dop-pler on the differential diagnosis and TNM staging of benign or malignant breast neoplasm. Methods A cohort of 58 biop-sy-proved cases, who underwent US elastographic and Doppler US imaging, were included in the current study. The pathological results after operation were considered the‘gold standard’of diagnosis. ROC curves were used to compare the changing rates of the diameter and area, elastographic indices and Doppler blood flow score in diagnosis of breast cancer. Re-sults Compared with other indices, the area changing rate showed the highest diagnostic ability with the AUC=0.914. More-over, the combined use of the elastography and color Doppler US increased the AUC to 0.981. The elastographic indices for neoplasm in the advanced-stage (stageⅡ~Ⅳ) were high than those of early-stage (stage 0~Ⅰ). The elastographic and Dop-pler scores increased with the progress of the TNM stages. Conclusion The changing rate of elastographic area can be used to accurately diagnose the breast neoplasm. Moreover, the combined use of US elastography and color Doppler US can in-crease the accuracy of the diagnosis, and may also provide useful information for the TNM staging.
出处 《天津医药》 CAS 北大核心 2014年第2期119-122,I0005,共5页 Tianjin Medical Journal
基金 国家自然科学基金资助项目(项目编号:81301217)
关键词 超声检查 弹性成像技术 乳腺肿瘤 超声检查 多普勒 彩色 肿瘤分期 ultrasonography elasticity imaging techniques breast neoplasm ultrasonography,Doppler,color neo-plasm staging
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