乳腺癌二维超声、彩色多普勒血流显像、剪切波弹性成像、造影参数联合评估与病理对照

目的  分析乳腺癌超声多参数(二维高频超声、彩色多普勒血流显像、剪切波弹性成像、造影)评估与病理对照。方法  选择2018年4月~2020年9月我院诊治的乳腺占位性病变患者61例(72个病灶)，均行二维高频超声、彩色多普勒血流显像、剪切波弹性成像、造影和病理检查，以术后病理检查结果为金标准。计算各种检查方法诊断乳腺癌的敏感度、准确度。结果  术后病理诊断结果示：61例(72个病灶)中有43例恶性(51个病灶)，18例良性(21个病灶)；二维高频超声诊断乳腺癌敏感度47.06%，特异性66.67%，准确度52.78%；彩色多普勒血流显像敏感度60.78%，特异性71.43%，准确度63.89%；剪切波弹性成像敏感度82.35%，特异性80.95%，准确度81.94%；超声造影敏感度86.27%，特异性85.71%，准确度86.11%；联合诊断敏感度94.12%，特异性90.48%，准确度93.06%。联合诊断乳腺癌准确率高于单独二维、彩色多普勒血流显像、剪切波弹性成像、造影检查(P < 0.05)。结论  乳腺癌超声多参数(二维、彩色多普勒血流显像、剪切波弹性成像、造影)联合检查，可明显提高乳腺癌诊断的准确率。

Evaluation of ultrasound multiple parameters (two-dimensional,color Doppler flow imaging,shear wave elastography,contrast-enhanced imaging) in breast cancer versus pathological control

  Objective  To compare the multimodal ultrasonographic parameters (two-dimensional high frequency ultrasound, color Doppler flow imaging (CDFI), shear wave elasticity imaging, contrast-enhanced ultrasound) and clinicopathological appearances of breast cancer.  Methods  Sixty-one patients (72 lesions) with breast space occupying lesions from April 2018 to September 2020 in our hospital were enrolled. Two-dimensional high frequency ultrasound, color Doppler flow imaging, shear wave elasticity imaging, contrast-enhanced ultrasound and pathological examinations were performed on all patients. Using pathological results as gold standard, the sensitivity and accuracy of each examination in the diagnosis of breast cancer were analyzed.  Results  Pathological results showed that among 61 patients (72 lesions), 43 were malignant (51 lesions) and 18 were benign (21 lesions). In the diagnosis of breast cancer, the sensitivity, specificity and accuracy were 47.06%, 66.67% and 52.78% through two-dimensional high frequency ultrasound, those of color Doppler flow imaging were 60.78%, 71.43% and 63.89%, and those of shear wave elasticity imaging were 82.35%, 80.95% and 81.94%, and those of contrast-enhanced ultrasound were 86.27%, 85.71% and 86.11%. The sensitivity, specificity and accuracy of combined examinations in the diagnosis of breast cancer were 94.12%, 90.48% and 93.06%, respectively. The accuracy of combined examination in the diagnosis of breast cancer was higher than that of single examination (P < 0.05).  Conclusion  Combined examinations can significantly improve accuracy of diagnosis of breast cancer, which is highly consist with pathological results.