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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

王旭1,黄淑华2,刘新红1,张璋3   

  1. 1. 天津市第四中心医院
    2. 天津市第四中心医院超声科
    3. 天津医科大学总医院
  • 收稿日期:2013-07-23 修回日期:2013-10-05 出版日期:2014-02-15 发布日期:2014-02-15
  • 通讯作者: 张璋

Evaluation of the combination use of ultrasonographic elastography and color Doppler on breast neoplasm diagnosis and TNM staging

  • Received:2013-07-23 Revised:2013-10-05 Published:2014-02-15 Online:2014-02-15
  • Contact: Zhang Zhang

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摘要： 目的 拟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+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、恶性乳腺肿块方的诊断效能较高，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。

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

Abstract: Objective To investigate the effect of the combined use of ultrasonographic (US) elastography and color Doppler US on breast neoplasm diagnosis and TNM staging. Methods A cohort of 58 biopsy-proved cases, who underwent US elastographic and Doppler US imaging, were included in the current study. The diagnostic abilities of the different elastographic indices (changing rate of the diameter and area, elastographic coefficient, Doppler blood flow score) were compared by using the ROC curves. Results Comparing to other indices, the area changing rate had the highest diagnostic ability with the AUC=0.914. Moreover, the combination use of the elastography and color Doppler US could increase the AUC to 0.981. All the elastographic indices of the advanced-stage (stage Ⅱ~Ⅳ) neoplasm were high than the early-stage (stage 0~Ⅰ) ones. The elastographic and Doppler scores both increased with the progress of the TNM stages. Conclusion The elastographic area changing rate could be used to accurately diagnose the breast neoplasm. Moreover, the combined use of US elastography and color Doppler US could increase the accuracy for the diagnosis, and may also provide useful information for the TNM staging.

Key words: Ultrasonography, Elasticity imaging techniques, breast neoplasm, Ultrasonography, Doppler, color, Neoplasm staging