彩色多普勒超声弹性成像在乳腺超声检查中的应用分析

目的 对彩色多普勒超声弹性成像在乳腺超声检查中的应用情况进行分析与探讨.方法 随机抽取2009年3月～2012年3月我院收治的乳腺肿瘤患者150例,均经过病理检查确诊.对其采用彩色多普勒超声弹性成像法进行检查,将检查结果与病理检查结果进行对比分析,评价彩色多普勒超声弹性成像法诊断乳腺肿瘤的准确性.结果 经比较分析发现,彩色多普勒超声弹性成像法诊断乳腺肿瘤的准确率为93.3％.结论 彩色多普勒超声弹性成像法在乳腺超声检查中具有较高的正确性,应用价值显著,值得临床推广.     

实时超声弹性成像技术在乳腺良恶性疾病鉴别诊断中的应用

超声技术在乳腺疾病的诊断中发挥着越来越重要的作用,常规二维超声,彩色多普勒及脉冲多普勒能在对病灶大小,位置,边缘情况,内部回声,血流情况,阻力指数等方面提供很多重要信息。随着医学领域对生物体的组织弹性和超弹性特性的关注,在传统二维超声成像基础上同时使用结合了组织弹性自相关方法的超声弹性成像技术,使组织的质地差异通过超声图像表现出来。该项技术能够获得常规超声所不能探测到的组织弹性信息,在对病变的良恶性鉴别诊断中起到了很大的作用。     

超声影像检查在乳腺癌诊断中的应用

乳腺癌是严重危害女性健康的疾病之一.近20年来,尽管乳腺癌的发病率逐年上升,但随着早期筛查、影像诊断和综合治疗水平的提高,乳腺癌的死亡率在发达国家反而明显下降[1].超声检查是乳腺肿瘤的常规检查方法之一,从20世纪80年代的灰阶超声、实时超声,到20世纪90年代以来的彩色多普勒超声、三维超声、声学造影、超声弹性成像及超声光散射乳腺成像等的应用,使超声检查对乳腺癌的诊断率和鉴别诊断率逐渐提高,对乳腺癌临床诊疗指导意义日趋增大[2,3].现将超声影像检查在乳腺癌诊断中的应用发展情况综述如下.     

超声Micro Pure成像技术在乳腺病灶微钙灶诊断中的临床应用

目的：探讨超声MicroPure成像技术在乳腺病灶微钙灶诊断中的临床应用价值。方法方选取我院超声科检查的乳腺癌疑似患者87例进行研究,分别对研究患者行常规超声检查和超声M icro Pure成像技术的方法检测乳腺肿物微钙化情况,比较两种检测方法的差别。结果超声MicroPure成像技术对微钙化肿瘤检出率为94．4％,明显高于常规超声检测技术的检出率（68．3％）。二者检出效率相比差异显著（ P ＜0．05）。MicroPure成像技术对恶性肿瘤微钙化病灶的检出率（95．9％）与常规超声技术（64．9％）相比,显著偏高（ P ＜0．05）。而两种检测方法对良性肿瘤微钙化的检出率无显著差异（ P＞0．05）。超声MicroPure成像技术可以清晰显示肿块微钙化的形态特征,为肿瘤良恶的鉴别提供参考指标。结论超声MicroPure成像技术在乳腺肿物微钙化检出中具有较大优势,可以清晰显示肿瘤微钙化情况,有助于乳腺癌的早期发现和治疗,是临床乳腺癌早期检查的较好选择。     

常规超声及超声弹性成像对乳腺肿块的定性诊断价值

目的:探讨常规超声、超声弹性成像及两者联合应用在乳腺肿块定性诊断中的价值。方法:421例经手术病理证实的乳腺肿块患者(464个乳腺肿块)行常规超声及超声弹性成像检查,分析常规超声、超声弹性成像及两者联合应用在乳腺肿块定性诊断中的准确性。结果:常规超声对乳腺肿块定性诊断的敏感度和特异度分别为81.09%和81.37%。超声弹性成像评分对乳腺肿块定性诊断的敏感度和特异度分别为88.56%和86.69%。超声弹性成像联合常规超声对乳腺肿块定性诊断的敏感度和特异度分别为92.04%和91.63%。3种方法对乳腺肿块定性诊断的敏感度及特异度差异均具有统计学意义(P=0.003)。结论:超声弹性成像在乳腺肿块定性诊断上较常规超声有一定优势,两者的联合应用有利于提高诊断的准确性。     

三维超声成像技术在乳腺癌诊断中的应用

乳腺癌是乳腺导管上皮及其末梢上皮发生的恶性肿瘤,是女性常见的恶性肿瘤之一,在西方国家其发病率和死亡率均为恶性肿瘤之首[1].近年来,乳腺癌的发病率呈不断上升趋势,对乳腺癌进行早期诊断,变得尤为重要.     

BI-RADS在乳腺超声诊断中的应用

<正> 1992年,美国放射学会(The American Collegeof Radiology,ACR)制定了乳腺影像学报告及数据系统(brest imaging reporting and data system,BIRADS)。该系统针对乳腺钼靶摄影影像进行了规范而详尽的描述,运用该系统对乳腺X线影像进行分级评估,对乳腺疾病诊断的敏感性、特异性及准确性均有较大提高。该标准2003年第4版修订时同     

超声弹性成像在乳腺肿瘤鉴别诊断中的临床价值分析

目的探讨超声弹性成像对乳腺良、恶性肿瘤鉴别诊断的应用价值。方法对收治的125例乳腺肿块分别采用超声弹性成像和彩色多普勒超声两种诊断方法进行检查。结果以弹性评分为4~5分高度预测恶性的标准,对比并统计超声弹性成像与彩色多普勒超声两种诊断方法在乳腺良恶性鉴别中效果,结果显示超声弹性成像的诊断灵敏性、特异性、准确性均明显高于彩色多普勒超声检查结果,且差异具有统计学意义(2=4.02、5.68、4.79,P0.05)。结论超声弹性成像是一种无创评价组织弹性的显像方式,可以用不同的评价方法对肿块进行更加客观的评价分析,其灵敏性、特异性、准确性均较彩色多普勒超声明显提高。     

动态光学乳腺成像在乳腺病灶鉴别诊断中的价值分析

目的：分析动态光学乳腺成像（DOBI）在鉴别乳腺良、恶性病灶中的应用价值。方法：对乳腺局灶性病变74例先进行常规超声检查,再根据超声测量病灶最大径分为〈1cm组、1～2cm组和〉2cm组进一步行DOBI扫描,并将诊断结果与病理结果进行对照分析。结果：〈1cm组DOBI诊断的敏感度、特异度和准确率均高于超声检查（P〈0．05）;1～2cm组两种检查无统计学差异（P〉0．05）;〉2cm组DOBI低于超声诊断（P〈0．05）。结论：对〈1cm的乳腺病灶,超声检查后行DOBI扫描可提高诊断的敏感度、特异度和准确率。     

超声弹性成像应变率比值法在乳腺良恶性结节鉴别诊断中的应用

目的:探讨超声弹性应变率比值法在乳腺良恶性结节鉴别诊断中的应用。方法:74例共82个病灶均行常规超声检查,测量病灶的应变率比值,并以病理结果作为对照。结果:82个病灶中,良性57个,恶性25个,良、恶性乳腺肿块弹性应变率比值分别为1.71±0.53和3.93±0.85,二者差异有统计学意义(P0.001)。应变率比值法对乳腺良恶性结节的敏感度、特异度、准确度分别为93.1%、94.9%、89.1%。结论:超声弹性应变率比值法有助于乳腺良恶性结节的鉴别,具有一定的临床应用价值。     

Clinical impact of the use of additional ultrasonography in diagnostic breast imaging

The degree of adherence with evidence-based guidelines for the use of breast ultrasonography was determined in clinical practice of radiologists in six hospitals. Additional ultrasonography was performed in 2,272 (53%) of all 4,257 patients referred for mammography. High adherence rates (mean: 95%) were observed for guidelines recommending ultrasonography in patients referred for palpable breast masses and abnormal screening and diagnostic mammograms. Lower adherence rates (mean: 81%, Pearson correlation coefficient = −0.57; p = 0.001) were found for guidelines advising against additional ultrasonography in patients referred for breast symptoms, a known benign abnormality, a family history or anxiety of breast cancer. The overuse of ultrasonography in 442 patients and underuse in 95 patients led to five additional false-positive results. It was concluded that the guidelines seem workable and feasible in clinical practice and that the current daily routine of diagnostic breast imaging corresponded to a great extent to the guidelines proposed.     

高频超声与X线钼靶对早期乳腺癌的诊断价值

目的 分析比较高频超声、X线钼靶单独及两者联合应用对早期乳腺癌的诊断价值.方法 体检发现乳腺包块、怀疑乳腺肿瘤的258例患者,行高频超声、X线钼靶的单独检查和联合检查,并行手术治疗.对照分析手术病理与影像学表现.结果 258例患者,手术病理证实早期乳腺恶性肿瘤135例,良性乳腺肿瘤123例.对于诊断早期乳腺癌,联合检查的敏感性优于单独的高频超声检查或X线钼靶检查(P<0.05),准确性优于X线钼靶检查(P<0.05),特异性、阳性预测值、阴性预测值、假阳性、假阴性等指标3组间均无显著差异(P均>0.05).对于早期乳腺癌患者,高频超声和X线钼靶相比,检出的钙化灶较少(18.3% vs 36.5%,P<0.01),能够发现更多的乳腺癌腋窝淋巴结转移(69.0% vs 33.3%,P<0.01).结论 高频超声与X线钼靶的单独和联合检查对于早期乳腺恶性肿瘤均为可靠的影像学诊断方法,联合应用诊断早期乳腺癌具有较高的敏感性和准确性.     

高频超声检测乳腺癌与乳腺纤维腺瘤诊断价值的探讨

目的:探讨高频超声和彩色多普勒(CDFI)对乳腺良、恶性肿瘤的形态及血流动力学特点,对鉴别良、恶性肿瘤的诊断价值。方法:应用高频超声结合CDFI技术对146例乳腺肿瘤的声像图特征及血流动力学与病理结果对照分析。结果:146例乳腺肿瘤中,乳腺纤维腺瘤90例,符合率94.4%,浸润性导管癌56例,符合率91.1%。结论:乳腺癌的特征性表现为形态不规则,毛刺状或蟹爪状,致密小钙化灶和后方回声衰减,CDFI:RI>0.75。乳腺纤维腺瘤的特征性表现为边界清晰,形态规则,有包膜和侧边声影,CDFI:RI<0.75。但是部分良、恶性肿瘤有交叉表现。     

超声检查在乳腺黏液腺癌诊断中的临床应用价值

目的：探讨超声检查在乳腺黏液腺癌诊断中的临床应用价值。方法收集我院乳腺黏液腺癌患者52例,根据不同病理类型分为2组,均予术前进行彩色超声检查,比较2组超声下肿瘤病灶的形态特点及血流特征。结果本组单纯型乳腺黏液腺癌病灶直径平均（3．25±1．23）cm ,混合型乳腺黏液腺癌直径平均（3．57±1．17）cm ,二者相比较差异无统计学意义（ t ＝0．953,P ＝0．258）。单纯型乳腺黏液腺癌组形态规则、内部回声均匀、病灶边界清晰、周围组织侵润情况,与混合型乳腺黏液腺癌相比较差异均具有统计学意义（ P ＜0．05）,后方回声增强与否二者相比差异则不具有统计学意义（ P ＞0．05）。本组单纯型乳腺黏液腺癌病例平均SPVmax （19．56±8．48）cm/s ,混合型乳腺黏液腺癌者平均SPV-max （25．24±9．78）cm/s ,两者比较差异具有统计学意义（ t ＝7．821,P ＝0．002）。单纯型乳腺黏液腺癌病例平均RI （0.82±0．08）,乳腺增生组RI为（0．76±0．12）,两组间比较差异不具有统计学意义（ t ＝1．0．12,P ＝0．198）。结论超声检查乳腺乳腺黏液腺癌形态特征明显,临床诊断价值较高。     

Clinical performance of PET/CT in evaluation of cancer: additional value for diagnostic imaging and patient management.

This study assessed the clinical performance of a combined PET/CT system using (18)F-FDG in oncologic patients. METHODS: (18)F-FDG PET/CT was used to evaluate 204 patients with 586 suspicious lesions. All patients had available follow-up data, enabling assessment of the clinical significance of hybrid PET/CT findings. Differences in interpretation between PET, CT, and fused PET/CT data were prospectively documented for detection, localization, and characterization of each evaluated site. The additional value of PET/CT for data interpretation over that of separate PET and CT was classified into several criteria, including change in lesion characterization to either definitely benign or definitely malignant, precise anatomic localization of malignant (18)F-FDG uptake, and retrospective lesion detection on PET and CT. The clinical impact of information provided by PET/CT on patient management was assessed on the basis of follow-up data concerning further diagnostic or therapeutic approach. Analysis of data was performed for the whole study population, for different types of cancer, and for different anatomic sites. RESULTS: PET/CT provided additional information over the separate interpretation of PET and CT in 99 patients (49%) with 178 sites (30%). PET/CT improved characterization of equivocal lesions as definitely benign in 10% of sites and as definitely malignant in 5% of sites. It precisely defined the anatomic location of malignant (18)F-FDG uptake in 6%, and it led to retrospective lesion detection on PET or CT in 8%. The results of PET/CT had an impact on the management of 28 patients (14%). Hybrid PET/CT data obviated the need for further evaluation in 5 patients, guided further diagnostic procedures in 7 patients, and assisted in planning therapy for 16 patients. CONCLUSION: Hybrid PET/CT improves the diagnostic interpretation of (18)F-FDG PET and CT in cancer patients and has an impact on both diagnostic and therapeutic aspects of patient management.     

Appropriate use of breast imaging modalities

Technological advancements in breast imaging continue to improve the ability to diagnose breast cancer early, particularly in women with dense breast tissue. Modalities other than mammography characterize areas of concern identified on screening mammograms to improve specificity of the screening system and reduce biopsies performed on negative lesions. With new breast imaging techniques and modalities constantly emerging, staying current has become difficult. This article reviews the role of current and emerging imaging modalities in screening, diagnosing, and continued assessment for breast cancer, as well as the currently accepted appropriate uses of each.     

Adjunctive diagnostic value of ultrasonography evaluation in patients with suspected ductal breast disease

PURPOSE: The purpose of this study was to evaluate the adjunctive diagnostic value of breast ultrasonography (US) in the study of benign ductal breast disease. MATERIALS AND METHODS: Fifty-two patients underwent US examinations for bloody nipple discharge, palpable retroareolar masses, retroareolar opacities or ductal pattern on mammography. US enabled visualisation of mammary-duct ectasia (simple or pseudocystic, retroareolar and/or peripheral) and focal masses (endoluminal or periductal, with ill-defined or regular margins). All patients with nipple discharge underwent cytological evaluation. After the US examination, all focal masses with ill-defined margins underwent fine-needle aspiration biopsy (FNAB), if necessary. The benign alterations were followed up. RESULTS: In 38/52 cases, US diagnosed mammary-duct ectasia and in 30/52 cases, the presence of focal masses (mean size 7 mm). In the nine women who underwent biopsy, histopathological evaluation diagnosed five solitary papillomas, one solitary papilloma with a focal area of ductal carcinoma in situ (DCIS), two multiple papillomas of the nipple and one papillomatosis. CONCLUSIONS: High-frequency US plays an important role in the detection of benign ductal disease both for the diagnosis and classification of focal masses and mammary-duct ectasia. US can be used as a complementary imaging method to galactography or as a valuable alternative when galactography is not available.     

Magnetic resonance imaging of the posterior cruciate ligament. Clinical use to improve diagnostic accuracy.

This study was undertaken to determine the accuracy of magnetic resonance image scanning in detecting posterior cruciate ligament injury, and to determine those clinical situations where it can add the most useful information. A retrospective study was conducted on 201 patients who underwent surgery after magnetic resonance scanning of their knees. Two additional patients who did not have surgery but had clinical findings grossly positive for posterior cruciate ligament injury were included in the analysis of magnetic resonance imaging accuracy. In all, there were 190 intact and 13 torn posterior cruciate ligaments. In a review of the clinical findings in the 11 patients with surgically documented tears, we found that all 11 had positive magnetic resonance scans. In 4 of the 11, magnetic resonance imaging provided especially useful information regarding the status of the ligament. For the 190 normal ligaments, there were no false-positive scans; for the 13 torn ligaments, there were no false-negative scans. Therefore, specificity and sensitivity estimates for this group were both 100%. Magnetic resonance imaging proved to be an accurate modality for evaluating the integrity of the posterior cruciate ligament. If used in the proper setting, it can provide useful information for diagnosing posterior cruciate ligament injuries.