超微血管成像技术对乳腺良恶性结节血管特征诊断价值

    Diagnostic value of superb microvascular imaging in the vascular characteristics of benign and malignant breast nodules

    • 摘要:
      目的通过超微血管成像技术(superb microvascular imaging, SMI)分析乳腺良恶性结节中的血管特征表现,判断此项技术的运用前景与价值。
      方法选取乳腺肿瘤病人75例,其中确诊为乳腺良性肿瘤病人45例,乳腺恶性肿瘤病人30例,共获得有效病灶结节94个,其中良性结节45个(良性组),恶性结节49个(恶性组)。通过SMI观察血管走向、血管主干与分支夹角、穿支血管和血管数量4项病变血管特征,以病理结果作为金标准,根据乳腺良恶性结节内血管特征的不同表现,采用ROC曲线分析SMI技术鉴别乳腺恶性结节内部血管特征的临界值,并进一步分析得出其敏感性与特异性指标。
      结果在SMI技术的视角下,2组血管走行方向、血管主干与分支夹角、穿支血管差异均有统计学意义(P < 0.01),2组血管丰富情况差异无统计学意义(P>0.05)。SMI诊断乳腺恶性结节的ROC曲线下面积为0.879,敏感性91.84%、特异性75.56%、准确性67.39%、阳性预测值80.4%、阴性预测值89.5%。
      结论SMI可以很好地反映乳腺良恶性结节内部血管特征区别,对于乳腺恶性病变有较好的诊断价值。

       

      Abstract:
      ObjectiveTo analyze the vascular characteristics in benign and malignant breast nodules using superb microvascular imaging (SMI), and judge the application prospect and value of this technology.
      MethodsA total of 75 patients with breast cancer were selected, among them, 45 patients were diagnosed as benign breast tumors, 30 patients with malignant breast cancer.A total of 94 effective lesions and nodules were obtained, there were 45 nodules in benign group, 49 nodules in malignant group.Four pathological vascular characteristics were observed through SMI, including the direction of blood vessels, the angle between main vessels and branches, perforator vessel and vessel number.Taking pathological results as the gold standard, according to the different manifestations of vascular characteristics in benign and malignant breast nodules, ROC curve was used to analyze the cut-off value of SMI technology to identify the internal vascular characteristics of malignant breast nodules, and its sensitivity and specificity were further analyzed.
      ResultsFrom the perspective of SMI technology, there was significant difference in direction of blood vessels, angle between main blood stream and branch, and perforator vessel number(P < 0.01), however, there was no significant difference in the vascular abundance between the two groups(P>0.05).The area under the ROC curve of SMI in the diagnosis of breast malignant nodules was 0.879, the related indicators were also obtained, including sensitivity (91.84%), specificity(75.56%), accuracy(67.39%), positive predictive value (80.4%), and negative predictive value (89.5%).
      ConclusionsSMI can well reflect the difference of internal vascular characteristics between benign and malignant breast nodules, and has a good diagnostic value for malignant breast lesions.

       

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