文章摘要

常规超声联合自动乳腺全容积成像及超声光散射技术对乳腺癌的诊断价值

作者: 1,2李瑞霞, 3刘娟, 2王惠, 2马苏美
1 兰州大学第一临床医学院，兰州 730000
2 兰州大学第一医院超声科，兰州 730000
3 兰州大学第一医院乳腺病科，兰州 730000
通讯: 马苏美 Email: lzmsm6711@163.com
DOI: 10.3978/j.issn.2095-6959.2022.08.011
基金: 甘肃省自然科学基金(1606RJZA118)。

摘要

目的：探讨常规超声、自动乳腺全容积成像(automatic breast volume scanner，ABVS)、超声光散射技术(diffuse optical tomography，DOT)及三者联合在乳腺癌诊断中的价值。方法：采用前瞻性研究方法，利用常规超声、ABVS及DOT检查72例患者共86个乳腺病灶，进行常规超声及ABVS的乳腺影像与数据报告(breast imaging reporting and date system，BI-RADS)分类，并获得DOT的综合诊断指数与数据报告(synthetic diagnostic index reporting and date system，SDI-RADS)分类。以术后病理结果为“金标准”，绘制常规超声、ABVS、DOT单独及三者联合诊断乳腺良恶性病灶的接收者操作特征(receiver operating characteristic，ROC)曲线，并分析诊断效能。分析常规超声、ABVS、DOT及三者联合诊断乳腺良恶性病灶曲线下面积(area under the ROC curve，AUC)的差异。结果：ABVS、常规超声诊断乳腺良恶性病灶的截断值为BI-RADS 4B类，DOT为SDI-RADS 4B类。常规超声、ABVS、DOT及三者联合诊断的AUC分别为0.768、0.893、0.902、0.780。ABVS与常规超声、ABVS与联合诊断、DOT与常规超声、DOT与联合诊断的AUC差异有统计学意义(分别P=0.0001、0.0052、0.0053、0.0010)；常规超声与联合诊断、ABVS与DOT的AUC差异无统计学意义(分别P=0.7695、0.8471)。联合诊断的灵敏度为93.88%，高于常规超声(73.47%)、ABVS (79.59%)及DOT (89.80%)(均P<0.0001)。结论：超声新技术ABVS与DOT诊断乳腺良恶性病灶具有较高价值。联合诊断并不能提高乳腺癌的诊断准确度、降低误诊率，但可提高检出率。
关键词： 乳腺病灶；超声检查；自动乳腺全容积成像；超声光散射

Diagnostic value of conventional ultrasound combined with ABVS and diffuse optical tomography in breast cancer

Authors: 1,2LI Ruixia, 3LIU Juan, 2WANG Hui, 2MA Sumei
1 First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
2 Department of Ultrasound, First Hospital of Lanzhou University, Lanzhou 730000, China
3 Department of Breast Diseases, First Hospital of Lanzhou University, Lanzhou 730000, China

CorrespondingAuthor: MA Sumei Email: lzmsm6711@163.com

DOI: 10.3978/j.issn.2095-6959.2022.08.011

Foundation: This work was supported by the Natural Science Foundation of Gansu Province, China (1606RJZA118).

Abstract

Objective: To evaluate the value of conventional ultrasound, automatic breast volume scanner (ABVS), diffuse optical tomography (DOT) and their combination for the diagnosis of breast cancer. Methods: In a prospective study, 86 breast lesions in 72 patients were examined by conventional ultrasound, ABVS and DOT. The breast imaging reporting and date system (BI-RADS) classification of conventional ultrasound and ABVS was performed, and the synthetic diagnostic index reporting and date system (SDI-RADS)  classification of DOT was obtained. Taking postoperative pathological results as the “gold standard”, the receiver operating characteristic (ROC) curves of conventional ultrasonography, ABVS, DOT alone and their combination for the diagnosis of benign and malignant breast lesions were drawn, and the diagnostic efficiency was analyzed. To analyze the difference of the area under the ROC curve (AUC) between benign and malignant breast lesions diagnosed by conventional ultrasound, ABVS, DOT and the combination. Results: The cut-off value of benign and malignant breast lesions diagnosed by ABVS and conventional ultrasound was BI-RADS 4B and DOT was SDI-RADS 4B. The AUC of conventional ultrasound, ABVS, DOT and their combined diagnosis were 0.768, 0.893, 0.902, and 0.780, respectively. There were statistically significant differences in AUC between ABVS and conventional ultrasound, ABVS and combined diagnosis, DOT and conventional ultrasound, DOT and combined diagnosis (P=0.0001, 0.0052, 0.0053, 0.0010, respectively). There was no significant difference in AUC between conventional ultrasound and combined diagnosis, ABVS and DOT (P=0.7695, 0.8471, respectively). The sensitivity of combined diagnosis was 93.88%, which was higher than conventional ultrasound (73.47%), ABVS (79.59%), and DOT (89.80%) (all P<0.0001). Conclusion: The new ultrasound techniques ABVS and DOT are of high value for the diagnosis of benign and malignant breast lesions. Combined diagnosis cannot improve the diagnostic accuracy and reduce the misdiagnosis rate of breast cancer, but can improve the detection rate.

Keywords： breast lesion; ultrasound; automated breast volume scanning; diffuse optical tomography

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