超声自动乳腺全容积扫查对乳腺肿块诊断额外临床价值的研究
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摘要
目的探讨超声自动乳腺全容积扫查(ABVS)在乳腺肿块诊断中对比手动超声是否具有额外的临床价值。方法对124例行乳腺肿块切除的患者,行手动超声和ABVS检查,比较ABVS是否较手动超声多发现新的肿块,以及ABVS是否在冠状面有特殊发现并据此对BI-RADS分级校正。结果 124例患者手动超声发现166个肿块,其中恶性肿块50个,良性肿块116个。ABVS较手动超声多发现8个肿块,其中恶性肿块4个,良性肿块4个。ABVS冠状面"汇聚征","火山口征","太阳征"对乳腺肿块良恶性的鉴别诊断的灵敏度为37.0%、特异度为92.5%,乳腺肿块经ABVS扫查,BI-RADS分类校正前后,ROC曲线下面积分别为0.89和0.93,两组比较差异无统计学意义(P>0.05)。结论 ABVS在鉴别诊断乳腺肿块良恶性的临床价值上,较手动超声多的有限;但其连续的不间断的自动扫查,有助于发现手动超声忽略的微小病灶。
Objective To investigate the extra clinical value of automated breast volume scanning(ABVS)in the diagnosis of breast tumor compare to hand-handle ultrasound(HHUS).Methods 124 patients with breast tumor were performed HHUS and ABVS before operation.The research focused on whether there were newly found tumors or new findings on the coronal planes by using ABVS compared to HHUS.Then the classification adjustments of BIRADS were made according to new findings on the coronal planes by using ABVS.Results There are totally 166 breast tumors found in 124 patients by HHUS,while 8more were observed by ABVS,4of which were malignant and the rest were benign.The sensitivity and specificity of ABVS coronal plane findings were 37.0%and 92.5%.The area under ROC curve was 0.89 before the corrected classification VS 0.93 after the corrected classification,there were no significant differences(P>0.05).Conclusions There was no significant extra clinical value in differentiating diagnosis of malignant tumors and benign breast tumors by ABVS comparing to HHUS.However,those minimal lesions missed diagnosis could be found by ABVS with continuously automatic scanning.
Objective To investigate the extra clinical value of automated breast volume scanning(ABVS)in the diagnosis of breast tumor compare to hand-handle ultrasound(HHUS).Methods 124 patients with breast tumor were performed HHUS and ABVS before operation.The research focused on whether there were newly found tumors or new findings on the coronal planes by using ABVS compared to HHUS.Then the classification adjustments of BIRADS were made according to new findings on the coronal planes by using ABVS.Results There are totally 166 breast tumors found in 124 patients by HHUS,while 8more were observed by ABVS,4of which were malignant and the rest were benign.The sensitivity and specificity of ABVS coronal plane findings were 37.0%and 92.5%.The area under ROC curve was 0.89 before the corrected classification VS 0.93 after the corrected classification,there were no significant differences(P>0.05).Conclusions There was no significant extra clinical value in differentiating diagnosis of malignant tumors and benign breast tumors by ABVS comparing to HHUS.However,those minimal lesions missed diagnosis could be found by ABVS with continuously automatic scanning.
引文
[1]江艳丽,温钊,吴楠,等.自动乳腺全容积超声成像在乳腺实性病灶诊断中的应用价值[J].中国超声医学杂志,2013,29(9):786-789.
[2]严丽霞,黄备建,刘利民,等.乳腺病灶声像图冠状面征象的应用价值[J].中国超声医学杂志,2014,30(11):980-983.
[3]谢迎东,徐超丽,魏淑萍,等.常规超声与自动乳腺全容积成像对浸润性导管癌三维测量的对比分析[J].临床超声医学杂志,2016,18(6):384-388.
[4]赵明子,刘玉萍,帅平,等.自动乳腺全容积成像冠状面“火山口征”的诊断价值[J].中国临床医学影像杂志,2013,24(3):159-160.
[5]谭艳娟,包凌云,黄安茜,等.乳腺恶性肿瘤冠状面汇聚征与临床病理学相关因素分析[J].中国超声医学杂志,2015,31(7):587-589.
[6]Zheying M,Cui C,Yitong Z et al.Diagnostic performance of the automated breast volume scanner:a systematic review of inter-rater reliability/agreement and meta-analysis of diagnostic accuracy for differentiating benign and malignant breast lesions[J].European Radiology,2015,25(12):3638-3647.
[7]严丽霞,黄备建,刘利民,等.汇聚征与乳腺浸润性导管癌临床病理特征的相关性[J].中华超声影像学杂志,2014,23(12):1057-1060.
[8]包凌云,谭艳娟,朱罗茜,等.自动乳腺全容积成像在乳腺导管原位癌诊断中的应用价值[J/OL].中华医学超声杂志(电子版),2015,11(1):61-67.
[9]郑逢洋,黄备建,严丽霞,等.乳腺癌冠状面汇聚征和生物学行为指标间的相关性研究[J].中华超声影像学杂志,2016,25(6):496-501.
[2]严丽霞,黄备建,刘利民,等.乳腺病灶声像图冠状面征象的应用价值[J].中国超声医学杂志,2014,30(11):980-983.
[3]谢迎东,徐超丽,魏淑萍,等.常规超声与自动乳腺全容积成像对浸润性导管癌三维测量的对比分析[J].临床超声医学杂志,2016,18(6):384-388.
[4]赵明子,刘玉萍,帅平,等.自动乳腺全容积成像冠状面“火山口征”的诊断价值[J].中国临床医学影像杂志,2013,24(3):159-160.
[5]谭艳娟,包凌云,黄安茜,等.乳腺恶性肿瘤冠状面汇聚征与临床病理学相关因素分析[J].中国超声医学杂志,2015,31(7):587-589.
[6]Zheying M,Cui C,Yitong Z et al.Diagnostic performance of the automated breast volume scanner:a systematic review of inter-rater reliability/agreement and meta-analysis of diagnostic accuracy for differentiating benign and malignant breast lesions[J].European Radiology,2015,25(12):3638-3647.
[7]严丽霞,黄备建,刘利民,等.汇聚征与乳腺浸润性导管癌临床病理特征的相关性[J].中华超声影像学杂志,2014,23(12):1057-1060.
[8]包凌云,谭艳娟,朱罗茜,等.自动乳腺全容积成像在乳腺导管原位癌诊断中的应用价值[J/OL].中华医学超声杂志(电子版),2015,11(1):61-67.
[9]郑逢洋,黄备建,严丽霞,等.乳腺癌冠状面汇聚征和生物学行为指标间的相关性研究[J].中华超声影像学杂志,2016,25(6):496-501.