切换至 "中华医学电子期刊资源库"

中华医学超声杂志(电子版) ›› 2020, Vol. 17 ›› Issue (12) : 1183 -1188. doi: 10.3877/cma.j.issn.1672-6448.2020.12.007

所属专题: 乳腺超声 文献

浅表器官超声影像学

自动乳腺全容积扫描正交三切面观察乳腺肿瘤边缘征象的应用价值
李逢生1,(), 袁权1, 宋灿许1, 王云梅2, 马珍珍1, 曹羽1, 程颢1, 田燕1   
  1. 1. 710061 西安交通大学医学院附属陕西省肿瘤医院超声医学科
    2. 710061 西安交通大学医学院附属陕西省肿瘤医院肿瘤内科
  • 收稿日期:2019-12-07 出版日期:2020-12-01
  • 通信作者: 李逢生
  • 基金资助:
    陕西省卫健委计划项目(2018D030)

Value of automatic breast volume scanning system in observing peripheral signs of breast tumors

Fengsheng Li1,(), Quan Yuan1, Canxu Song1, Yunmei Wang2, Zhenzhen Ma1, Yu Cao1, Hao Cheng1, Yan Tian1   

  1. 1. Department of Ultrasound, Shanxi Cancer Hospital Affiliated to Medical School of Xi’an Jiaotong University, Xi'an 710061, China
    2. Department of Oncology, Shanxi Cancer Hospital Affiliated to Medical School of Xi’an Jiaotong University, Xi'an 710061, China
  • Received:2019-12-07 Published:2020-12-01
  • Corresponding author: Fengsheng Li
  • About author:
    Corresponding author: Li Fengsheng, Email:
引用本文:

李逢生, 袁权, 宋灿许, 王云梅, 马珍珍, 曹羽, 程颢, 田燕. 自动乳腺全容积扫描正交三切面观察乳腺肿瘤边缘征象的应用价值[J/OL]. 中华医学超声杂志(电子版), 2020, 17(12): 1183-1188.

Fengsheng Li, Quan Yuan, Canxu Song, Yunmei Wang, Zhenzhen Ma, Yu Cao, Hao Cheng, Yan Tian. Value of automatic breast volume scanning system in observing peripheral signs of breast tumors[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(12): 1183-1188.

目的

分析自动乳腺全容积扫描(automated breast volume scanner,ABVS)正交三切面观察乳腺肿瘤边缘征象的应用价值。

方法

回顾性分析2017年4月至2019年5月于陕西省肿瘤医院行乳腺外科手术并经术后病理证实的女性乳腺肿瘤患者206例共计292个病灶。所有患者术前均行ABVS检查,比较ABVS正交3个不同切面病灶边缘征象对乳腺良恶性肿瘤的诊断效能,并对正交三切面评价乳腺良恶性肿瘤的总体诊断效能进行分析。

结果

292个病灶中,良性148个,恶性144个。以外科术后病理结果为"金标准",冠状面毛刺征诊断乳腺癌的敏感度为68.05%,与横切面的17.36%和矢状面的13.19%相比,差异均有统计学意义(χ2=5.63、41.19,P均<0.05)。冠状面边缘成角诊断乳腺癌的敏感度为42.36%,与横切面的26.38%和矢状面的22.22%相比,差异均有统计学意义(χ2=16.00、21.73,P均<0.001)。ABVS正交3个切面的病灶微小分叶和边缘模糊征象诊断乳腺癌的敏感度比较,差异均无统计学意义(P均>0.05)。ABVS正交三切面边缘微小分叶、毛刺征、边缘成角和边缘模糊诊断乳腺癌的敏感度、特异度、阳性预测值、阴性预测值和准确性分别为81.94%、86.48%、85.50%、83.11%、84.24%;68.75%、96.62%、95.19%、76.06%、82.87%;47.22%、95.27%、91.89%、64.97%、71.57%;54.16%、57.43%、55.31%、56.29%、55.82%。

结论

ABVS冠状面毛刺征和边缘成角评价乳腺良恶性肿瘤具有优势,诊断敏感度优于矢状面与横切面。与其他边缘征象相比,微小分叶的综合评价效能具有稳定性,是诊断恶性结节敏感度和准确性最佳的表面特征。

Objective

To assess the diagnostic value of automated breast volume scanning (ABVS) in comparing and observing the peripheral signs of breast tumors on three orthogonal sections.

Methods

A retrospective analysis was performed on 206 women with 292 breast tumors who underwent breast surgery and postoperative pathological diagnosis at Shanxi Provincial Cancer Hospital from April 2017 to May 2019. ABVS was performed in all patients before operation to compare the diagnostic efficacy of ABVS on three different orthogonal sections for breast benign and malignant tumors, and to analyze the overall diagnostic efficacy of ABVS on three orthogonal sections for breast benign and malignant tumors.

Results

Of the 292 lesions, 148 were benign and 144 were malignant. Using the postoperative pathological results as the "gold standard", the sensitivity of coronal burr sign (68.05%) was significantly higher than that of transverse (17.36%) and sagittal (13.19%) sign (P<0.05). The sensitivity of coronal edge angulation (42.36%) was also significantly higher than that of transverse (26.38%) and sagittal (22.22%) edge angulation (P<0.001).There was no significant difference in the sensitivity of lobular and marginal fuzzy signs for the diagnosis of breast cancer (P>0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of edge microlobulation, burr, edge angulation, and edge blur on ABVS were 81.94%, 86.48%, 85.50%, 83.11%, and 84.24%), 68.75%, 96.62%, 95.19%, 76.06%, and 82.87%, 47.22%, 95.27%, 91.89%, 64.97%, and 71.57%, and 54.16%, 57.43%, 55.31%, 56.29%, and 55.82%, respectively.

Conclusion

Coronal burr sign and marginal angulation on ABVS are superior to those on sagittal and transverse sections in the evaluation of benign and malignant breast tumors with regard to diagnostic sensitivity. Compared with other peripheral features, micro-lobulation is the most sensitive and accurate surface feature for the diagnosis of malignant nodules.

图1 乳腺恶性肿瘤自动乳腺全容积扫描及病理图像。图a为超声自动乳腺全容积扫描图像矢状面显示病灶边缘模糊(箭头所示);图b为横切面显示病灶边缘成角(箭头所示);图c为冠状面显示病灶呈"汇聚征";图d为冠状面显示病灶边缘成角(箭头所示);图e为乳腺病灶大体标本(箭头所示为超声图像对应的显示病灶边缘成角的部位);图f为术后病理结果示浸润性导管癌(HE ×100)
图2 乳腺良性肿瘤自动乳腺全容积扫描图像。图a示侵袭性纤维腺瘤冠状面亮环征;图b示侵袭性纤维腺瘤矢状面呈边缘微小分叶;图c示纤维腺瘤横切面边缘浅分叶状;图d示纤维腺瘤冠状面呈暗环征
表1 ABVS正交三切面病灶毛刺征与术后病理评价乳腺良恶性肿瘤的诊断结果比较(例)
表2 ABVS正交三切面病灶边缘成角与术后病理评价乳腺良恶性肿瘤的诊断结果比较(例)
表3 ABVS正交三切面病灶微小分叶与术后病理评价乳腺良恶性肿瘤的诊断结果比较(例)
表4 ABVS正交三切面病灶边缘模糊与术后病理评价乳腺良恶性肿瘤的诊断结果比较(例)
表5 ABVS正交三切面边缘征象与术后病理评价乳腺良恶性肿瘤的诊断结果比较(例)
表6 ABVS对292个乳腺良恶性肿瘤的总体诊断效能分析(%)
1
Alzheimer's Association. 2016 Alzheimer's disease facts and figures [J]. Alzheimers Dement, 2016, 12(4): 459-509.
2
Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever [J]. Bull World Health Organ, 2004, 82(5): 346-353.
3
Chan SW, Cheung PS, Chan S, et al. Benefit of ultrasonography in the detection of clinically and mammographically occult breast cancer [J]. World J Surg, 2008, 32(12): 2593-2598.
4
Girometti R, Zanotel M, Londero V, et al. Comparison between automated breast volume scanner (ABVS) versus hand-held ultrasound as a second look procedure after magnetic resonance imaging [J]. Eur Radiol, 2017, 27(9): 3767-3775.
5
Zheng FY, Lu Q, Huang BJ, et al. Imaging features of automated breast volume scanner: Correlation with molecular subtypes of breast cancer [J]. Eur J Radiol, 2017, 86: 267-275.
6
Kim YW, Kim SK, Youn HJ, et al. The clinical utility of automated breast volume scanner: a pilot study of 139 cases [J]. J Breast Cancer, 2013, 16(3): 329-334.
7
Zheng FY, Yan LX, Huang BJ, et al. Comparison of retraction phenomenon and BI-RADS-US descriptors in differentiating benign and malignant breast masses using an automated breast volume scanner [J]. Eur J Radiol, 2015, 84(11): 2123-2129.
8
A.Thomas Stavros. 乳腺超声经典诊断学 [M]. 王知力, 译. 北京: 科学出版社, 2017.
9
Kotsianos-Hermle D, Hiltawsky KM, Wirth S, et al. Analysis of 107 breast lesions with automated 3D ultrasound and comparison with mammography and manual ultrasound [J]. Eur J Radiol, 2009, 71(1): 109-115.
10
Chen L, Chen Y, Diao XH, et al. Comparative study of automated breast 3-D ultrasound and handheld B-mode ultrasound for differentiation of benign and malignant breast masses [J]. Ultrasound Med Biol, 2013, 39(10): 1735-1742.
11
Zhang J, Lai XJ, Zhu QL, et al. Interobserver agreement for sonograms of breast lesions obtained by an automated breast volume scanner [J]. Eur J Radiol, 2012, 81(9): 2179-2183.
12
周建华, 韩若凌, 纪晓惠, 等. 自动全容积成像乳腺病灶冠状面声像图特征分析 [J]. 中华超声影像学杂志, 2017, 26(2): 174-175.
13
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.
[1] 王亚红, 蔡胜, 葛志通, 杨筱, 李建初. 颅骨骨膜窦的超声表现一例[J/OL]. 中华医学超声杂志(电子版), 2024, 21(11): 1089-1091.
[2] 李洋, 蔡金玉, 党晓智, 常婉英, 巨艳, 高毅, 宋宏萍. 基于深度学习的乳腺超声应变弹性图像生成模型的应用研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 563-570.
[3] 周荷妹, 金杰, 叶建东, 夏之一, 王进进, 丁宁. 罕见成人肋骨郎格汉斯细胞组织细胞增生症被误诊为乳腺癌术后骨转移一例[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 380-383.
[4] 唐金侨, 叶宇佳, 王港, 赵彬, 马艳宁. 医学影像学检查方法在颞下颌关节紊乱病中临床应用研究进展[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 406-411.
[5] 高杰红, 黎平平, 齐婧, 代引海. ETFA和CD34在乳腺癌中的表达及与临床病理参数和预后的关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 64-67.
[6] 韩萌萌, 冯雪园, 马宁. 乳腺癌改良根治术后桡神经损伤1例[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 117-118.
[7] 张志兆, 王睿, 郜苹苹, 王成方, 王成, 齐晓伟. DNMT3B与乳腺癌预后的关系及其生物学机制[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 624-629.
[8] 王玲艳, 高春晖, 冯雪园, 崔鑫淼, 刘欢, 赵文明, 张金库. 循环肿瘤细胞在乳腺癌新辅助及术后辅助治疗中的应用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 630-633.
[9] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[10] 郑大雯, 王健东. 胆囊癌辅助诊断研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 769-773.
[11] 李浩, 陈棋帅, 费发珠, 张宁伟, 李元东, 王硕晨, 任宾. 慢性肝病肝纤维化无创诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 863-867.
[12] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[13] 王子阳, 王宏宾, 刘晓旌. 血清标志物对甲胎蛋白阴性肝细胞癌诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 677-681.
[14] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
[15] 胡云鹤, 周玉焯, 付瑞瑛, 于凡, 李爱东. CHS-DRG付费制度下GB1分组住院费用影响因素分析与管理策略探讨[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 568-574.
阅读次数
全文


摘要