摘要
目的探讨多普勒超声定量参数在肉芽肿性乳腺炎(GLM)和乳腺浸润性导管癌(IDC)诊断及鉴别中的应用。方法选择12例GLM和21例IDC患者,所有患者均行CDFI检查,比较GLM、IDC肿块内部与边缘收缩期峰值流速(PSV)、舒张末期流速(EDV)与阻力指数(RI),并比较GLM、IDC肿块内部与边缘PSV、EDV、RI差值;绘制受试者工作特征(ROC)曲线分析其对GLM、IDC的诊断鉴别价值。结果GLM内部血流PSV、EDV明显低于边缘血流(t分别=3.86、2.97,P均<0.05),但GLM肿块内部RI与边缘RI比较,差异无统计学意义(t=1.44,P>0.05)。IDC肿块内部PSV、EDV、RI与边缘PSV、EDV、RI比较,差异均无统计学意义(t分别=0.65、0.33、0.21,P均>0.05)。GLM肿块内部PSV、EDV与边缘PSV、EDV差值明显高于IDC(t分别=4.23、4.16,P均<0.05),但GLM肿块内部RI与边缘RI差值比较,差异无统计学意义(t=1.03,P>0.05)。PSV鉴别GLM、IDC的曲线下面积(AUC)为0.83(P<0.05),临界值为≤2.9 cm/s,灵敏度、特异度分别为71.43%、91.67%;EDV鉴别的AUC为0.83(P<0.05),临界值为≤2 cm/s,灵敏度、特异度分别为80.95%、75.00%;但PSV与EDV鉴别GLM、IDC的AUC值比较,差异无统计学意义(Z=0.08,P>0.05)。结论GLM患者CDFI影像所示肿块内部血流PSV、EDV与边缘血流存在明显差异,或可作为临床诊断鉴别GLM、IDC的重要依据。
Objective To investigate the application of Doppler ultrasound in the diagnosis and differentiation of gran-ulomatous lobular mstitis(GLM)and breast invasive ductal carcinoma(IDC).Methods Totally 12 patients with GLM and 21 patients with IDC were selected and subjected to CDFI examination.The internal and marginal peak systolic velocity(PSV),end-diastolic velocity(EDV)and resistance index(RI)of GLM and IDC,as well as internal and marginal difference values of above indicators were compared.The value in the differential diagnosis of GLM and IDC was analyzed with the receiver operating characteristic(ROC)curve.Results The internal PSV and EDV of GLM masses were significantly lower than those of marginal blood flow(t=3.86,2.97,P<0.05).However,there was no significant difference between internal RI and marginal RI in GLM masses(t=1.44,P>0.05).The comparison of internal and marginal PSV,EDV and RI of IDC masses showed no significant differences(t=0.65,0.33,0.21,P>0.05).The difference values of internal and marginal PSV and EDV of GLM masses were significantly higher than those of IDC(t=4.23,4.16,P<0.05),there was no significant difference in the difference value of internal and marginal RI of GLM masses(t=1.03,P>0.05).The AUC of PSV in the differential diagnosis of GLM and IDC was 0.83(P<0.05),with 2.9 cm/s as the critical value,the sensitivity and specificity were 71.43%and 91.67%respectively.The AUC of EDV was 0.83(P<0.05),with 2 cm/s as the critical value,the sensitivity and specificity were 80.95%and 75.00%,respectively.There was no significant difference in AUC between PSV and EDV in the differential diagnosis of GLM and IDC(Z=0.08,P>0.05).Conclusion There are obvious differences in PSV and EDV of GLM masses displayed by CDFI,which may be used as an important basis for clinical diagnosis and differential diagnosis.
作者
陆超
姚春
涂美琳
姚洁
谷美玉
LU Chao;YAO Chun;TU Meilin(Department of Ultrasound Medicine,Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310000,China)
出处
《全科医学临床与教育》
2021年第12期1088-1091,共4页
Clinical Education of General Practice
基金
浙江省医药卫生科技计划项目(2020KY756)。
关键词
彩色多普勒血流显像
肉芽肿性乳腺炎
乳腺浸润性导管癌
诊断鉴别
color Doppler flow imaging
granulomatous lobular mastitis
breast invasive ductal carcinoma
diag-nosis and differentiation
