目的:评价超声光散射乳腺成像技术对常规超声诊断中疑似恶性乳腺肿块良恶性的诊断价值及系统提供的量化指标与病理结果的相关性.方法:将2011年4-5月来武汉协和医院行常规超声检查疑似恶性乳腺肿块(常规超声能诊断的典型囊肿、纤维腺瘤不纳入)的52名患者进行超声光散射成像技术检查,将其与手术病理结果进行对比,并对系统提供的量化指标与病理结果行相关性分析,分析该技术的诊断准确性.结果:至2011年11月底,共45名患者接受手术治疗.根据评分结果,该45名患者中,评分在1～3级的23名,4～5级22名.手术病理结果:良性26名,恶性19名,灵敏度89.5％(17/19),特异度80.8％(21/26),阳性预测值77.3％(17/22),阴性预测值91.3％(21/23).综合诊断指标(P=O.000)、血红蛋白总量(P=0.025)、肿物方向(P=O.009)、形态因子(P=O.001)在良恶性两组间均有统计学差异.分项指标中,血红蛋白总量及肿物方向进入Logistic回归方程,血红蛋白总量(标准回归系数2.817)比肿物方向(标准回归系数1.180)相关性更大.结论:超声光散射成像技术对乳腺疾病的良恶性有较好的鉴别能力,其提供的血红蛋白总量与肿块的良恶性有直接相关性,其他部分指标与肿块良恶性也具有一定的相关性,为临床提供了量化依据.%Objective: To assess the diagnostic value of diffused optical imaging with ultrasound(OPTIMUS) in differentiating benign and malignant breast tumors and the correlation between the quantitative parameters from the report of OPTIMUS and pathological results. Methods: We selected 52 patients with suspected malignant breast tumors by ultrasound (excluding those with typical cysts and fibroadenomas) in Wuhan Union Hospital from April to May of 2011. The breast tumors of the patients were examined by OPTIMUS. The diagnostic accuracy of the OPTIMUS and the correlation between the quantitative parameters and pathological results were analyzed by comparing the reports and pathological results. Results: Forty-five patients had accepted surgery treatments before November 2011. OPTIMUS reported 23 tumors with BI-RADS 1～3 and 22 tumors with BI-RADS 4～5, and pathological results showed that 26 tumors were benign and 19 tumors were malignant. The sensitivity, specificity, positive predictive value, negative predictive value of the diagnosis of OPTIMUS were 89.5% (17/19), 80.8%(21/26), 77.3%(17/22), 91.3%(21/23), respectively. There were significant differences in the comprehensive diagnostic parnrameters(P=0.000), total hemoglobin(P=0.025), tumor direction(P=0.009), shape factor(P=0.001) between benign and malignant tumors. In sub-parameters, total hemoglobin and tumor direction entered the Logistic regression equation, and total hemoglobin (standardized regression coefficient 2.817) was more relevant to tumor direction(standardized regression coefficient 1.180). Conrnclution: OPTIMUS has effective identification of benign and malignant breast tumors. Total hemoglobin, as a new quantitative parameter, is directly related to the nature of tumor pathology, and some sub-parameters are related to the nature of tumor pathology. OPTIMUS provides quantitative information for clinical diagnosis.
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