兩種第二眼超聲檢查在乳腺高危病灶中的診斷價值研究

蘇昆侖 徐海濱 張正賢 徐子寧 崔鳳 胡祖健 何俊玲 楊歐歐 劉玲琳 羅華

兩種第二眼超聲檢查在乳腺高危病灶中的診斷價值研究

蘇昆侖 徐海濱 張正賢 徐子寧 崔鳳 胡祖健 何俊玲 楊歐歐 劉玲琳 羅華

目的 對比自動乳腺全容積掃查系統(ABVS)與手持式超聲(HHUS)作為第二眼超聲檢查對MRI檢出的高危乳腺病灶的診斷價值。方法 采用前瞻性研究方法，選取MRI檢出乳腺高危病灶的患者116例，共132個高危病灶，均行ABVS和HHUS作為第二眼超聲檢查。以病理學檢查結果為標準，比較ABVS、HHUS在診斷乳腺良惡性病灶上的差異，以及兩者對不同MRI影像特征病灶的檢出情況。結果 ABVS的乳腺高危病灶檢出率高于HHUS（76.5%vs 69.7%，P＜0.05）；而兩種超聲檢查在診斷乳腺良惡性病灶上的差異比較無統計學意義（P＞0.05），ABVS、HHUS對MRI影像特征上不同大小、內部強化類型、時間-信號增強曲線類型的病灶檢出率比較差異均無統計學意義（均P＞0.05），而對不同增強類型的病灶檢出率比較差異有統計學意義（P＜0.05），兩種超聲檢查對非腫塊強化型病灶的檢出率均低于對腫塊型病灶的檢出率。結論 對于乳腺高危病灶，ABVS作為第二眼超聲檢查比HHUS檢出率更高，但兩者對非腫塊強化型的病灶檢出率均不高。

乳腺腫瘤 超聲檢查 第二眼 成像，三維 磁共振檢查 診斷

【 Abstract】 Objective To compare the diagnostic value of automated breast volume scanner(ABVS)and hand-held ultrasound(HHUS)as second-look ultrasound examinations for high-risk breast lesions on MRI. Methods One hundred and sixteen patients with 132 high-risk lesions on breast MRI were enrolled in the study.The patients underwent HHUS and ABVS examinations as second-look ultrasound modalities.Based on pathologic findings,the value of ABVS and HHUS in differential diagnosis of benign and malignant breast lesions was compared;and the detection rates of two modalities for lesions with different characteristics on MRI were analyzed. Results The detection rate of ABVS for high-risk lesions was higher than that of HHUS(76.5%vs.69.7%,P＜0.05),but there was no significant difference in differential diagnosis of benign and malignant breast lesions.The detection rate of two ultrasound methods was no statistically different for lesions with different size,internal enhancement patterns and TIC curves on MRI(P＞0.05),but there was significant difference in detection of lesions with different enhancement types on MRI between two methods.The detection rate of non-mass lesions was lower than that of mass-type lesions by both methods. Conclusion ABVS is more effective than HHUS in detection of high-risk lesions as the second-look ultrasound examination.However,both techniques have limitations in detecting non-mass enhancement.

【 Key words】 Breast neoplasms Ultrasonography Second-look Imaging,three-dimensional Magnetic resonance imaging Diagnosis

乳腺MRI是乳腺疾病重要的檢查方法，診斷靈敏 度高，但特異度較差，假陽性率較高，因此對于檢出的可疑病灶必須經病理學檢查結果確診[1-2]。MRI引導下的病灶穿刺活檢由于費用較高、耗時較長，限制了其在臨床的應用。……