超微血管成像技术联合超声BI-RADS分级在鉴别乳腺良恶性肿物中应用价值

发布时间：2018-05-04 14:50

本文选题：乳腺肿瘤 + 超声检查　；参考：《中国临床医学影像杂志》2016年01期

【摘要】：目的:利用超微血管成像(SMI)技术,并与CDFI对比,以明确BI-RADS分级与SMI结合是否可以提高超声对恶性病变的诊断效能。方法:超声检出并术后病理证实的乳腺肿物138例,良性肿物78例,恶性肿物60例。按照Adler分级标准,分别观察同一肿物在CDFI和SMI技术所显示血流情况,并对肿物进行常规二维灰阶超声BI-RADS分级,使用受试者工作特征(ROC)曲线计算出BI-RADS,SMI及CDFI的Adler分级的鉴别良恶性乳腺病灶的最佳诊断界点,并根据此诊断界点得出以上单一模式及联合模式的诊断效能等相关指标。结果:SMI与CDFI的内部观察者间一致性较好(CDFI:κ=0.82;SMI:κ=0.76),两种检测方法在显示全部肿物血流丰富程度有明显差异(κ=0.38);在恶性肿物中上述差异更加明显(κ=0.028);而在良性肿物中差异不明显(κ=0.61)。分别得到的ROC曲线下面积分别为0.867(BI-RADS),0.669(CDFI),0.871(SMI),0.710(BI-RADS与CDFI联合模式)及0.899(BI-RADS与SMI联合模式)。其敏感性、特异性分别为0.950,0.692(BI-RADS);0.900,0.821(SMI);0.600,0.641(CDFI)。BI-RADS与SMI的联合模式的敏感性与BI-RADS单一模式相近,差异无统计学意义(0.900 vs 0.950,P0.05);而BI-RADS与SMI的联合模式的特异性明显高于BI-RADS单一模式(0.897 vs 0.692,P0.01)。结论 :与CDFI相比较,SMI检测肿物的微血管效果更好,SMI与BI-RADS联合可提高超声对乳腺恶性肿物的诊断效能。
[Abstract]:Objective: to determine whether the combination of BI-RADS grade and SMI can improve the diagnostic efficacy of ultrasound in malignant lesions by using the technique of supermicrovascular imaging (SI) and comparing with CDFI. Methods: 138 cases of breast tumor, 78 cases of benign tumor and 60 cases of malignant tumor were detected by ultrasound and confirmed by pathology. According to the Adler classification standard, the blood flow of the same tumor was observed by CDFI and SMI, and the tumor was classified by conventional two-dimensional gray scale ultrasound BI-RADS. The optimal diagnostic threshold for differentiating benign and malignant breast lesions from Adler classification of BI-RADSUS SMI and CDFI was calculated by using the operating characteristics of the subjects. The diagnostic efficacy of the single model and the combined mode was obtained according to the above diagnostic threshold. Results the consistency between the internal observers of CDFI and that of the two groups was good. There was a significant difference between the two methods in showing the blood flow richness of all tumors (魏 0.38), especially in malignant masses (魏 0.028), but not in benign masses (魏 0.61). The area under the ROC curve was 0.867 BI-RADS 0.669 ~ 0.871 ~ 0.871 ~ (0. 710) BI-RADS / CDFI) and 0.899(BI-RADS / SMI combined mode respectively. The sensitivity of BI-RADS was 0.950 ~ (0.692g) BI-RADS, respectively. The sensitivity of the combined model of BI-RADS and SMI was similar to that of the single model of BI-RADS, and the specificity of the combined model of BI-RADS and SMI was significantly higher than that of the single model of BI-RADS (0.897 vs 0.692p0.01g), and the sensitivity of BI-RADS was similar to that of the single model of BI-RADS (P 0.05), while the specificity of the combined model of BI-RADS and SMI was significantly higher than that of the single model of BI-RADS (0.897 vs 0.692p0.01). Conclusion: compared with CDFI, the combination of CDFI and BI-RADS can improve the diagnostic efficiency of breast malignant tumor.
【作者单位】：中国医科大学附属盛京医院超声科;
【基金】：中国医科大学附属盛京医院院内课题资助项目(MD63)
【分类号】：R737.9;R445.1

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