乳腺肿块超声血流显示的影响因素及其良恶性诊断价值

目的探讨乳腺肿块超声血流显示的影响因素及其对良、恶性肿块的鉴别诊断价值。方法对408个乳腺良、恶性肿块进行灰阶及彩色多普勒超声血流检查，分别记录其血流数、灰阶声像图特征进行回顾性分析。结果超声显示的血流数随肿块大小不同而具有显著差异，肿瘤后方衰减征象、内部坏死液性区征象在未检出血流的乳腺癌组中均显著高于有血流组。以超声检出的血流数为指标诊断乳腺良、恶性肿块的敏感性、特异性、阳性预测值、阴性预测值均较低。结论肿块大小、肿瘤后方衰减、内部坏死液性区征象均显著影响彩色多普勒超声对乳腺癌内血流的检测，超声检出的血流数不能作为乳腺良、恶性肿块鉴别诊断的直接有效依据。

Influencing factors and diagnostic value in breast tumorsof color Doppler flow imaging

Objective To evaluate the influencing factors of color Doppler flow imaging and its diagnostic value in differentiation between malignant and benign breast tumors. Methods Four hundred and eight tumors were examined by gray-scale and color Doppler ultrasonography, and the vessel numbers, gray-scale characteristics were recorded for further retrospective analysis. Results There were significant differences of color Doppler flow vessel numbers in tumors with different sizes. The signs of posterior acoustic shadowing, the interior necrotic or cystoid areas could be seen more in malignant tumors without vessels visualized than those with vessels. Using the vessel numbers as the only criteria for benign or malignant tumors had relatively lower sensitivities, specificities, positive predictive values and negative predictive values. Conclusion The size of the tumors and the signs of the posterior acoustic shadowing, the necrotic or cystoid areas in the tumors significantly affect the visualization of blood flow in breast tumors by color Doppler ultrasonography, so the vessel numbers can not be a useful criterion for differentiating malignant breast tumors from the benigns.