摘要
目的分析超声成像与正电子发射体层显像/计算机断层显像(PET/CT)在乳腺肿瘤良恶性鉴别及预后评估中的价值。方法回顾性分析2019年6月至2022年4月浙江金华广福医院收治的80例乳腺恶性肿瘤患者(恶性组)和同期80例乳腺良性肿瘤患者(良性组)的临床资料,所有患者分别接受超声成像和PET/CT检查。比较两组超声特征、彩色多普勒血流阻力指数(RI)、PET/CT病灶部位最大标准摄取值(SUVmax),分析不同诊断方式对乳腺肿瘤良恶性的诊断效能;恶性组患者根据是否存在淋巴结转移分为转移组和未转移组,比较两组RI、SUVmax;绘制受试者工作特征(ROC)曲线,分析超声成像与PET/CT预测乳腺恶性肿瘤患者预后的价值。结果恶性组的超声特征主要表现在形态不规则、边界不清晰、内部回声不均匀、后方回声衰减、伴钙化、血流Ⅱ~Ⅲ级、纵横比>1、RI≥0.7、UE≥4级。超声成像联合PET/CT诊断乳腺良恶性肿瘤的灵敏度、特异度、准确度为96.25%、97.50%、96.88%,均高于单独超声成像、PET/CT。恶性组RI、SUVmax高于良性组(0.88±0.19比0.65±0.15、8.97±3.18比1.84±1.04),转移组RI、SUVmax高于未转移组(1.10±0.22比0.83±0.18、13.37±3.67比7.31±2.12),差异均有统计学意义(P<0.05)。ROC曲线结果显示,RI、SUVmax及两者联合预测乳腺恶性肿瘤患者预后的曲线下面积分别为0.898(95%CI 0.806~0.989)、0.916(95%CI 0.832~1.000)、0.993(95%CI 0.974~1.000)。结论超声成像与PET/CT联合诊断可提高乳腺肿瘤良恶性的鉴别准确率,提高乳腺恶性肿瘤淋巴结转移检出率,为预后评估提供合理依据。
Objective To analyze the values of ultrasound imaging and positron emission tomography/computed tomography(PET/CT)imaging in the differential diagnosis of benign and malignant breast tumors and prognosis evaluation.Methods The clinical data of 80 cases of breast malignant tumors(malignant group)and 80 cases of breast benign tumors(benign group)treated in the Zhejiang Jinhua Guangfu Tumor Hospital from June 2019 to April 2022 were retrospectively analyzed.All patients underwent ultrasound imaging and PET/CT,respectively.The ultrasound characteristics,color Doppler flow resistance index(RI)and maximum standardized uptake value of PET/CT(SUVmax)were compared between the two groups,and the diagnostic efficacy of different diagnostic methods for benign and malignant breast tumors were analyzed.According to the different prognosis of patients in the malignant group(lymph node metastasis or not),they were divided into the metastatic group and the non-metastatic group.The RI and SUVmax value of the two groups were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the evaluation values of prognosis in the diagnosis of breast malignant tumors by ultrasound imaging and PET/CT imaging.Results The ultrasonic characteristics of the malignant group were irregular shape,unclear boundary,uneven internal echo,posterior echo attenuation,accompanied by calcification,blood flow gradeⅡ-Ⅲ,aspect ratio>1,RI≥0.7 and ultrasound elastography≥4 grade.The sensitivity,specificity and accuracy of ultrasound combined with PET/CT in the diagnosis of benign and malignant breast tumors were 96.25%,97.50%,96.88%,and were higher than those of single imaging.The RI and SUVmax values in the malignant group were higher than those in the benign group(0.88±0.19 vs.0.65±0.15,8.97±3.18 vs.1.84±1.04),and the RI and SUVmax values in the metastatic group were higher than those in the non-metastatic group(1.10±0.22 vs.0.83±0.18,13.37±3.67 vs.7.31±2.12),there were statistical differences(P<0.05).The results of ROC curve showed that the area under the curve of RI,SUVmax value and their combination to predict the prognosis of patients with breast malignant tumor were 0.898(95%CI 0.806-0.989),0.916(95%CI 0.832-1.000)and 0.993(95%CI 0.974-1.000),respectively.Conclusions The combined diagnosis of ultrasound imaging and PET/CT imaging can improve the differential accuracy of benign and malignant breast tumors,increase the diagnosis rate of lymph node metastasis of malignant breast tumors,and provide a reasonable basis for prognosis evaluation.
作者
全志伟
焦婷婷
楼伟兵
陆海健
Quan Zhiwei;Jiao Tingting;Lou Weibing;Lu Haijian(Department of Ultrasound Medicine,Zhejiang Jinhua Guangfu Cancer Hospital,Jinhua 321000,China;Department of Nuclear Medicine,Zhejiang Jinhua Guangfu Cancer Hospital,Jinhua 321000,China)
出处
《中国医师进修杂志》
2024年第4期361-365,共5页
Chinese Journal of Postgraduates of Medicine
