乳腺血氧功能成像技术与多普勒超声的联合应用在乳腺癌早期诊断中的意义

目的探讨乳腺血氧功能成像技术与多普勒超声（彩超）的联合应用在乳腺肿块诊断中的应用价值。方法选择2010年12月～2012年3月深圳市宝安区人民医院收治的乳腺单发肿块患者225例,进行乳腺血氧功能成像和/或彩超检查,并分别予穿刺病理活检、手术切除病理检查。以病理诊断为校正标准,分别分析乳腺血氧功能成像诊断、彩超诊断及两者联合诊断的敏感性、特异性、阳性预测率、及阴性预测率。结果血氧功能成像检查敏感度为91.9%（34/37）,特异度为88.3%（166/188）,阳性预测值为61.8%（34/55）,阴性预测值为98.2%（167/170）;彩超检查敏感度为86.8%（33/38）,特异度为85.6%（160/187）,阳性预测值为52.4%（33/63）,阴性预测值为98.8%（160/162）;两种检查方法之间各指标差异均无统计学意义（P〉0.05）。血氧与彩超联合检查的敏感度为97.4%（37/38）,特异度为90.3%（169/187）,阳性预测值为67.3%（18/55）,阴性预测值为99.4%（169/170）。血氧与彩超联合检查的敏感度、特异度、阳性预测值等指标显著高于单项血氧功能成像检查或彩超检查（P〈0.05）,而血氧与彩超联合检查的阴性预测值则与单项血氧功能成像检查或彩超检查差别无统计学意义（P〉0.05）。结论血氧功能成像技术单独应用于乳腺肿瘤诊断在敏感性、特异性等方面比乳腺彩超并无明显优势,但由于血氧功能成像无创、操作方便、成本低等特点,总体上仍优于彩超。血氧功能成像与乳腺彩超联合明显提高乳腺肿瘤诊断的敏感性和特异性,因此可作为常规乳腺影像学检查的有效的辅助手段,对乳腺癌的早期诊断及普查具有重要意义。

Clinical application value of breast blood oxygen functional image technology combined with Doppler ultrasound in the diagnosis of breast cancer

Objective To investigate the clinical value of breast blood oxygen functional image（BOI） combined with Doppler ultrasound（DU） in diagnosis of breast cancer.Methods 225 cases of breast masses in People＇s Hospital of Bao＇an District in Shenzhen City from December 2010 to March 2012 were selected and tested with BOI and/or DU,aspiration biopsy,surgical removal and pathological examination were used too.The rates of sensitivity,specificity,positive prediction and negative prediction were calculated for BOI,DU,and BOI jointed with DU with pathological diagnosis as the check standard.Results The rates of sensitivity,specificity,positive prediction value,and negative prediction value diagnosed by BOI alone were respectively 91.9%（34/37）,88.3%（166/188）,61.8%（34/55）,and 98.2%（167/170）.The rates of sensitivity,specificity,positive prediction value,and negative prediction value diagnosed by DU alone were 86.8%（33/38）,85.6%（160/187）,52.4%（33/63） and 98.8%（160/162）.There was no significant differ ence between the diagnostic efficiency of BOI and DU（P 0.05）.The rates of sensitivity,specificity,positive prediction value,and negative prediction value diagnosed by BOI jointed with DU were 97.4%（37/38）,90.3%（169/187）,67.3%（18/55）,and 99.4%（169/170） which were all significantly higher than that of BOJ or DU alone（P 0.05）.Conclusion BOJ has no advantage over DU in sensitivity,specificity,positive prediction value and negative prediction value for the diagnosis of breast carcinoma.However,BOJ is more harmless,convenient and inexpensive than DU.BOI jointed with DU can promote the sensitivity and specificity for breast carcinoma significantly,it is an effective assisting aid for the diagnosis of breast carcinoma.