标题：多普勒高频超声在乳腺良性病变与微小癌鉴别中的应用价值

      作者：刘锋，周芳菲，官华芳，詹秀英    (鹰潭市人民医院功能科，江西 鹰潭 335000)

      卷次： 2018年29卷23期

      【摘要】 目的 探讨多普勒高频超声在乳腺良性病变与微小癌鉴别诊断中的价值。方法 回顾性分析2015年2月至2018年2月鹰潭市人民医院收治的经病理证实100例乳腺微小癌患者和90例乳腺良性病变患者的临床资料，所有患者均行多普勒高频超声检查，以病理结果为标准，分析多普勒高频超声表现鉴别诊断乳腺良性病变与微小癌的价值。结果 多普勒高频超声征象对比结果显示，乳腺微小癌和乳腺良性病变患者的纵横比>1 (20.0% vs16.7%)，结节后回声衰减(11.0% vs 8.9%)比较，差异均无统计学意义(P>0.05)；乳腺微小癌和乳腺良性病变患者的低回声(90.0% vs 42.2%)、边缘毛糙(83.0% vs 13.3%)、沙砾样微钙化(63.0% vs 14.4%)、穿支血流信号出现率(75.0% vs10.0%)，血流阻力(82.0% vs 5.6%)比较，乳腺微小癌均高于乳腺良性病变，差异均具有统计学意义(P<0.05)；多普勒高频彩超诊断乳腺微小癌的灵敏度、特异度、阳性预测值、阴性预测值、准确度分别为 80.00%、84.44%、85.11%、79.17%、82.11%，曲线下面积为0.830 (95%CI：0.729~0.931，P=0.000)。结论 多普勒高频超声可有效鉴别乳腺良性病变与微小癌，值得在临床中推广应用。
      【关键词】 乳腺良性病变；微小癌；高频超声；鉴别诊断
      【中图分类号】 R588 【文献标识码】 A 【文章编号】 1003—6350（2018）23—3342—03

Value of Doppler high frequency ultrasound in differential diagnosis between benign breast lesions andmicrocarcinoma.
LIU Feng, ZHOU Fang-fei, GUAN Hua-fang, ZHAN Xiu-ying. Department of Function, YingtanPeople's Hospital, Yingtan 335000, Jiangxi, CHINA
【Abstract】 Objective To evaluate the value of Doppler high-frequency ultrasonography in differential diagno-sis between benign breast lesions and microcarcinoma. Methods The clinical data of 100 patients with breast mi-cro-carcinoma and 90 patients with benign breast lesions confirmed by pathology in Yingtan People's Hospital from Feb-ruary 2015 to February 2018 were analyzed. All patients underwent Doppler high-frequency ultrasound examination.Taking the pathological results as the standard, the value of Doppler high-frequency ultrasonography in differential diag-nosis between benign breast lesions and microcarcinoma was analyzed. Results Comparison of Doppler high-frequen-cy ultrasound signs showed that there were no significant differences between the ratio of longitudinal and transverse ra-tio > 1 in the breast microcarcinoma and benign breast lesions (20.0% vs 16.7%), and the proportion of posterior echo at-tenuation in the nodules (11.0% vs 8.9% ), P>0.05. The proportion of hypoechoic (90.0% vs 42.2% ), rough margin(83.0% vs 13.3% ), gravel-like microcalcification (63.0% vs 14.4% ) and perforating branches (75.0% vs 10.0% ), andblood flow resistance (82.0% vs 5.6%) of breast microcarcinoma were all higher than those of benign breast lesions, andthe differences were statistically significant (P<0.05). The sensitivity, specificity, positive predictive value, negative predictivevalue and accuracy of Doppler ultrasonography in the diagnosis of breast microcarcinoma were 80.00% , 84.44% , 85.11% ,79.17% and 82.11%, respectively. The area under the curve was 0.830 (95% CI: 0.729-0.931, P=0.000). Conclusion Dopplerhigh-frequency ultrasound can effectively differentiate benign breast lesions from microcarcinoma, which is worthy ofpopularization in clinical practice.
      【Key words】 Benign breast lesions; Microcarcinoma; High frequency ultrasound; Differential diagnosis·论 著·doi:10.3969/j.issn.1003-6350.2018.23.027