双功彩色多普勒血流影像诊断乳腺癌的价值.docVIP

???? 双功彩色多普勒血流影像诊断乳腺癌的价值 ???? ???? [摘要]目的：评价乳腺癌双功彩色多普勒血流影像诊断的价值。材料与方法：用双功彩色多普勒超声检查152例158个乳腺肿块，定量分析彩色象素平均密度、峰值血流速度、RI值和血管数目。结果：乳腺癌彩色象素平均密度为6.1％±0.11％，高于良性肿块1.5％±0.1％(P0.01)；峰值血流速度为23.55±1.23cm/s，明显高于良性肿块5.73±0.39cm/s(P0.001)；阻力指数(RI)为0.71±0.11，明显高于良性肿块0.51±0.012(P0.01)；血管数目为1.67±0.063，明显高于良性肿块0.86±0.093(P0.01)。CDFI诊断乳腺癌的敏感性为88％，特异性82％，准确性89％。结论：CDFI、PD用于乳腺癌的诊断有较高的临床价值。[关键词]乳腺肿瘤；超声检查，多普勒，双功能[中分类号]R737.904.1；R730.261[文献标识码]A[文章编号]1008－1062(2000)03－0167－03 Diagnostic significance of duplex color Doppler in breast cancer HU Shu-fang(The First Affiliated Hospital of Nanjing Medical Science University,Nanjing 210029,China) Abstract:Objective:To evaluate the diagnostic significance of duplex color Doppler imaging in breast cancer.Materials and Methods:In 152 patients,158 masses of breast were investigated with duplex color Doppler imaging.MCPD,PSV， TAV,RI and vessel numbers were analysed quantitively.Result:MCPD,PSV,RI and vessel numbers in breast cancer 0. 061± 0. 001,23. 55± 1. 23cm/s,0. 71. ± 0. 011 and 1. 67± 0. 063 were higher than in benign breast group 0. 015± 0. 001,5. 73± 0. 39,0. 51± 0. 012 and 0. 86± 0. 093(P0. 01,P0. 001,P0. 01,and P0. 001 respectively.Diagnostic sensitivity,specifity and accuracy of CDFI for breast cancer were 88％ ,82％ ,89％ .Conclusion:CDFI may increase the diagnostic sensitivity,paticularity and accuracy in clinical diagnosis of breast cancer.Key words:breast neoplasms;ultrasonography,doppler,duplex 　　本文采用双功彩色多普勒血流显像对乳腺良恶性肿瘤血流进行定量和定性分析，结合病理，研究其对乳腺良恶性肿瘤的诊断价值。 1资料和方法 1.1研究对象　　我院1996年1月～1998年11月住院的乳腺肿瘤病人152例计158个肿块，均在术前1周内行双功彩色多普勒血流影像检查。年龄32～72岁，平均54.5岁。乳腺囊肿及复发性癌不包括在内，所有肿块均行病理学诊断。1.2仪器和检查方法　　采用Acuscn128XP/10和ATLHDI3000彩色多普勒声像仪，探头频率7.5MHz；彩阶6cm/s，同时录像和彩打机记录像。　　患者仰卧位，双臂上举，充分暴露双侧乳房和腋窝。首先用二维超声探查乳房肿块的大小、数量、边界、内部回声、后方和前侧壁回声，双腋窝淋巴结是否肿大。CDFI显像了解整个肿块内及肿块周边的血流，在彩流丰富处上下连续扫描直到肿块边缘，测肿块面积，点状血流以圆形计算，长条状血流以椭圆形计算，采用计算机定量计算彩色血流占肿块面积百分比即彩色象素平均密度[1](MCPD)、用PD取样计算PSV、EVD、Vm、RI值。　　根据肿块内血管数目将其分为：T0：无血流；T+：少量血流，内见1～3个点状血流；T：内见4～6个点状血流，1个条状血流，T：内见6～8个点状血流，2个条