彩色多普勒超声联合钼靶X射线影像在乳腺癌诊断中的价值

doi:10.3877/cma.j.issn.1673-5250.2015.04.013

目的

探讨联合应用彩色多普勒超声(以下简称为超声)与钼靶X射线2种检查方法诊断乳腺癌的价值。

方法

选择2014年1～11月，在苏州大学附属第二医院经术后组织病理检查确诊的98例乳腺癌患者为研究对象，共摘除乳腺肿块112枚。总结98例患者术前超声、钼靶X射线检查的声像学图像特征，并以术后组织病理检查为金标准，比较超声、钼靶X射线单独及联合使用对诊断乳腺癌的差异。

结果

本组112枚乳腺肿块的声像学图像特征如下。①超声：乳腺肿块形态不规则为96%(107/112)、边界不清为88%(99/112)、低回声为86%(96/112)、内部回声不均匀为85%(95/112)。②钼靶X射线：乳腺肿块形态不规则、内部回声不均匀的高密度肿块，与周围组织分界不清。③超声、钼靶X射线单独诊断乳腺癌的诊断准确率比较(83.04% vs 78.57%)，差异无统计学意义(χ²＝0.72，P＝0.400)；超声联合钼靶X射线诊断乳腺癌准确率(91.96%)显著高于二者单独检查的准确率，且差异均有统计学意义(χ²＝4.08，P＝0.040；χ²＝8.00, P＝0.005)。

结论

超声与钼靶X射线是诊断乳腺癌的重要影像学检查方法，二者联合应用可提高乳腺癌诊断的准确性，可为临床医师进行乳腺癌的术前评估和预后评价提供指导意义。

关键词: 超声检查，多普勒，彩色, 弹性成像技术, 乳房X线摄影术, 乳腺肿瘤

Objective

To evaluate the value of ultrasonography combined with mammography in diagnosis of breast cancer.

Methods

A total of 98 patients who were definitely diagnosed as breast cancer by pathological examination after surgery in the Second Affiliated Hospital of Suzhou University from January to November 2014 were chosen as study objects, and 112 masses were removed after surgery.All the patients underwent both ultrasonography and mammography examinations before operation, and the ultrasonogram features of both were summarized.The diagnostic accuracy of ultrasonography, mammography and the combination of these two methods were analysed according to results of pathological examination after surgery.

Results

①The main manifestation of ultrasonography results of 112 masses were: the irregular shape of lump was 96% (107/112), obscure boundary of lump was 88%(99/112), the hypoecho of lump was 86%(96/112) and the uneven echo of lump was 85%(95/112). ②The main features of ultrasonogram of mammography in breast cancer were irregular shape, uneven internal echo and high density masses, and has obscure boundary with surrounding tissues.③There was no significant difference between ultrasonography and mammography in diagnostic accuracy of breast cancer (83.04% vs 78.57%, χ²=0.72, P=0.400). The diagnostic accuracy of breast cancer of ultrasonography combined with mammography (91.96%)was higher than that of ultrasonography or mammography alone, and the differences were significant(χ²=4.08, P=0.040; χ²=8.00, P=0.005).

Conclusions

Ultrasonography and mammography were both important iconography examinations of breast cancer diagnosis.Combination of these two examinations can improve the diagnostic accuracy of breast cancer, and provide guidance of preoperative and prognostic evaluation for clinicist.

Key words: Ultrasonography, doppler, color, Elasticity imaging techniques, Mammography, Breast neoplasms

图1 乳腺癌患者肿块超声及超声弹性声像图(图1A：超声声像图；图1B：超声弹性声像图)(女性，52岁)注：黄色圈是做弹性成像时的取样

图2 本112枚肿块超声及其弹性成像的声像学特征注：1：低回声；2：边界不清；3：形态不规则；4：纵/横径≥1；5：内部回声不均匀；6：微小钙化；7：Adler血流分级为Ⅱ～Ⅲ级；8：后方衰减；9：乳管扩张；10：弹性成像评分≥3分

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摘要

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Diagnostic value of ultrasonography with mammography image in breast cancer patients

模态框（Modal）标题

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Diagnostic value of ultrasonography with mammography image in breast cancer patients