彩色多普勒超声与实时灰阶超声造影对乳腺肿瘤的诊断价值比较

目的 探讨实时灰阶超声造影与彩色多普勒超声对乳腺肿瘤的诊断价值。方法 对术前72名乳腺肿瘤患者进行彩色多普勒超声及实时灰阶超声造影检查,与病理结果进行对照分析乳腺良恶性肿瘤彩色多普勒超声及超声造影特征,比较两种方法的敏感性、特异性及诊断正确率。结果 (1)乳腺良恶性肿瘤彩色多普勒超声及超声造影特征不同,乳腺良性肿瘤多表现为0~Ⅰ级血流,RI＜0.7,而恶性以Ⅱ~Ⅲ级血流、RI≥0.7为主;乳腺良性肿瘤以等增强、均匀增强为主,恶性肿瘤以高增强、不均匀增强为主;(2)实时灰阶超声造影对乳腺肿瘤血供的敏感性(100%)明显高于彩色多普勒超声(79.2%);(3)彩色多普勒超声诊断乳腺肿瘤的敏感性、特异性、准确性分别为71.4%、80.0%、75.0%,Kappa值为0.50。超声造影诊断乳腺肿瘤的敏感性、特异性、准确性分别为76.2%、70.0%、73.6%,Kappa值为0.46。结论 实时灰阶超声造影对乳腺肿瘤血供的敏感性高,但对良恶性的鉴别意义并不优于彩色多普勒超声。

Color Doppler flow imaging and Real-time Gray-scale Contrast-enhanced Ultrasound in the diagnosis of breast tumor

Objective To investigate Color Doppler flow imaging and Real -time Gray -scale Contrast-enhanced Ultrasound in the diagnosis of breast tumor. Method We used Color Doppler flow imaging and Realtime Gray - scale Contrast - enhanced Ultrasound in the diagnosis of 72 breast tumor before operation. We compared with pathology result, the characteristic of Color Doppler flow imaging and Real - time Gray - scale Contrast-enhanced Ultrasound in benign tumor and malignant tumor. Then, we compared sensibility, specificity and coincidence. Result 1. Breast tumor has different characteristic of Color Doppler flow imaging and Contrast enhanced Ultrasound. 0-I grade blood flow and RI 〈 0.7 was found in most benign tumor. Ⅱ - Ⅲgrade blood flow and RI≥0.7 was found in most malignant tumor. Most benign tumor was enhanced by equal. Even most malignant tumor was enhanced by high and uneven. 2. Sensibility of Contrast - enhanced Ultrasound is 100% , obviously higher than that of Color Doppler flow imaging （ 79.2% ）. 3. Sensibility, specificity and coincidence of Color Doppler flow imaging is 71.4%o ,80.0% and 75.0% with Kappa value 0.50, which were 76.2% ,70.0% and 73.6% , respectirely referring Contrast - enhanced Ultrasound with Kappa value 0.46）. Conclusion Real - time Gray- scale Contrast- enhanced Ultrasound has more specificity in blood flow of tumor, but its differential diagnosis capability doesn＇t surpass Color Doppler flow imaging.