三维超声鉴别诊断乳腺肿块良恶性的优势

目的 探讨三维超声鉴别诊断乳腺肿块良恶性的优势征象.方法 由5名超声医师独立评估109例女性患者中120个乳腺实性肿块的二维及三维超声图像(手术病理诊断69个恶性,51个良性).评估内容包括肿块的7项二维及10项三维声像特征,通过受试者工作特征曲线(ROC) 分析比较三维超声相对于二维超声鉴别诊断肿块良恶性的优势.结果 二维及三维声像图上良恶性肿块的声像特征间各自均显著不同(P<0.001);三维声像上恶性特征显示率高于二维声像,其中三维冠状面上"汇聚征"诊断恶性的敏感性为56.8%、特异性为93.7%,边缘不规则或毛刺征诊断恶性的敏感性为92.2%,特异性为51.8%;完整界面回声诊断良性的敏感性为77.6%,特异性为90.4%.ROC分析显示三维与二维的曲线下面积分别为0.948 3和0.908 6(P<0.05).结论 三维超声提供更多的影像评估特征,使乳腺肿块的良恶性鉴别比二维超声更可靠.三维超声的诊断价值高于二维超声.

Advantage of Three-dimensional Ultrasound in the Differential Diagnosis of Benign and Malignant Breast Tumors

Objective To explore the advantage of three-dimensional (3D) ultrasound in the differential diagnosis of benign and malignant breast tumors.Methods 2D and the corresponding 3D ultrasound images of 120 breast solid lesions (69 malignant,51 benign) in the 109 female patients were independently analyzed by five ultrasound doctors.Characteristics of seven 2D and ten 3D ultrasound were investigated.The advantage of 3D ultrasound in comparison with 2D ultrasound was analyzed using receiver operating characteristics (ROC) curve.Results All of the investigated ultrasound criteria were highly significant in characterizing breast lesions.(P<0.001).The detection rate of diagnostic characteristics of malignant lesions in 3D ultrasound was higher than those in 2D ultrasound.The sensitivity and specificity of the retraction phenomenon in the coronal plane of the 3D ultrasound to indicate malignant lesions were 56.8% and 93.7% respectively,and those of the irregular or spiculate margin contour to indicate malignant lesions were 92.2% and 51.8% respectively.The sensitivity and specificity of the complete interface echo to indicate benign lesions were 77.6% and 90.4% respectively.The area under ROC curve for 3D and 2D ultrasound were 0.9483 and 0.9086 respectively(P<0.05).Conclusions 3D ultrasound can provide more evaluation characterization of the image.3D ultrasound is more reliable than conventional 2D ultrasound in differential diagnosis of breast tumors.The diagnostic value of 3D ultrasound was better than 2D ultrasound.