超微血管成像与能量多普勒超声对不同大小乳腺实性肿物诊断的对比研究

摘要

目的 比较超微血管成像(superb micro-vascular imaging,SMI)与能量多普勒(power Doppler imaging,PDI)在不同大小乳腺良恶性肿物诊断中的应用价值.方法 回顾性分析2016年8月至2017年7月在我院经超声检查发现乳腺实性肿物患者144例,共170个肿物,分别行PDI及SMI检查,并取得病理结果 .以最大径2.0 cm进行分组,通过对比两种检查方法评价血流分布 、 血管形态及血流分级的差异,比较两种检查方法的诊断效能.结果良性肿物68个,恶性肿物102个.肿物最大径 ≤2.0 cm时,PDI及SMI对良性肿物血流分布 、 血管形态及血流分级的评价差异均无统计学意义(P>0.05);对恶性肿物血管形态及血流分级的评价差异均有统计学意义(P<0.05),对血流分布的评价差异无统计学意义(P=0.174);两种方法鉴别乳腺良恶性肿物的ROC曲线下面积分别为0.724、0.844,诊断效能差异有统计学意义(P=0.024).当肿物最大径>2.0 cm时,PDI及SMI对良性肿物血流分布 、 血管形态及血流分级的评价差异均无统计学意义(P>0.05);对恶性肿物血管形态的评价差异具有统计学意义(P=0.001),对血流分布 、 血流分级的评价差异均无统计学意义(P>0.05).两种方法鉴别乳腺良恶性肿物的ROC曲线下面积分别为0.768、0.802,诊断效能差异无统计学意义(P=0.447).结论 SMI能够更清晰地显示肿物内血流特征,当肿物最大径 ≤2.0 cm时,其诊断效能优于PDI.%Objective To compare the diagnostic efficiency of superb micro-vascular imaging ( SMI) and power Doppler imaging ( PDI) in differentiating different size breast tumors . Methods Retrospective analysis were performent in a total of 170 cases of breast tumors of 144 patients screened with SMI and PDI in our hospital from August 2016 to July 2017 ,and pathological results were finally obtained . These tumors were divided into two groups according to the maximum diameter 2 .0 cm . SMI and PDI diagnostic efficiency were compared by showing blood flow distribution ,vascular morphology and Alder grade . Results There were 68 benign tumors and 102 malignant tumors .When the maximum diameter was no more than 2 .0 cm ,there were no significant difference in the blood flow distribution ,vascular morphology and Alder grade between PDI and SMI of benign tumors( all P > 0 .05) ;However ,there were significant differences in the vascular morphology and Alder grade of malignant tumors( all P < 0 .05) ,but no difference in blood flow distribution( P = 0 .174) ;The area under the curve of ROC by PDI and SMI were 0 .724 and 0 .844 ,thus , the difference was statistically significant( P = 0 .024) . When the maximum diameter was more than 2 .0 cm ,the between PDI and SMI differences in blood flow distribution ,vascular morphology and Alder grade were not statistically significant ( all P > 0 .05) in benign tumors ,but there was statistical difference in vascular morphology ( P = 0 .001) in malignant tumors ,and there was no significant difference in blood flow distribution ,Alder grade in malignant tumors between PDI and SMI ( all P > 0 .05) . The area under the curve of ROC by PDI and SMI were 0 .768 and 0 .802 ,the difference was not statistically significant ( P = 0 .447) . Conclusions SMI can show the blood flow characteristics more clearly in breast tumors . When the maximum diameter is no more than 2 .0 cm ,SMI diagnostic efficiency is better than PDI .