彩色多普勒超声成像在乳腺癌诊断及化疗效果评估中的意义

摘要

目的 分析彩色多普勒超声成像在乳腺癌诊断和化疗效果中的应用价值.方法 将经病理检查的75例乳腺癌患者,均行新辅助化疗、彩色多普勒超声检查、X线摄影检查;对比彩超成像、X线摄影诊断乳腺癌符合率、误诊率、漏诊率以及在各类型乳腺癌中的诊断价值.对比化疗前后病灶大小及血流峰值、阻力指数值,对比CR+PR组、SD+PD组化疗前后超声表现.结果 ①彩色超声成像诊断乳腺癌误诊率 (4.00％) 、漏诊率 (17.33％) 与X线摄影 (16.00％、5.33％) 差异显著,P ＜0.05.②彩色超声成像诊断腺癌、转移性肉瘤的符合率 (71.43％、100.00％) 较X线摄影 (50.00％、75.00％) 高,P ＜0.05.③化疗后肿瘤体积、面积、厚度、宽度、长度、血流峰值、阻力指数均显著下降,P ＜0.05.④化疗前两组均表现为肿瘤边界模糊,形态不规则,有蟹足样改变,内部回声不均匀,有液化或细簇样钙化灶,后方有声衰或回声强化.CR+PR组主要表现为比较规则的边界、形态、内部回声及后方回声.结论 彩色多普勒超声成像可用于乳腺癌诊断中,能辅助新辅助化疗效果观察.%Objective To analyze the value of color Doppler ultrasonography in the diagnosis and chemotherapy of breast cancer. Methods From December 2015 to March 2018, 75 patients with breast cancer were enrolled in the pathological examination of our hospital. All of them were treated with neoadjuvant chemotherapy, color Doppler ultrasonography and X-ray photography. The coincidence rate, misdiagnosis rate, missed diagnosis rate of breast cancer and diagnostic value in various types of breast cancer were compared by color ultrasound and X-ray. The size of lesion, peak blood flow and resistance index before and after chemotherapy were compared, The ultrasound manifestations of CR + PR group and SD + PD group before and after chemotherapy were compared. Results The misdiagnosis rate (4.00％) and missed diagnosis rate (17.33％) of breast cancer were significantly different from those of X-ray (16.00％) and 5.33％ (P ＜ 0.05). The coincidence rate of color ultrasound in diagnosis of adenocarcinoma and metastatic sarcoma (71.43％ and 100.00％) were higher than those of X-ray (50.00％ and 75.00％, P ＜0.05). After chemotherapy, the tumor volume, area, thickness, width, length, peak blood flow and resistance index decreased significantly (P ＜ 0.05). Before chemotherapy, the tumor boundary was blurred, the shape was irregular, the echo was not uniform, there were liquefied or fine clusters of calcified lesions, and there were acoustic attenuation or echo enhancement in the rear.Group CR + PR mainly showed regular border, shape, internal echo and rear echo. Conclusion Color Doppler ultrasonography can be used for the diagnosis of breast cancer, and which can assist neoadjuvant chemotherapy to observe efficacy.