Quantitative vascularity of breast masses by Doppler imaging: Regional variations and diagnostic implications
Quantitative vascularity of breast masses by Doppler imaging: Regional variations and diagnostic implications
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DOI：
10.7863/jum.2000.19.7.427
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发表时间：
2000-07-01
影响因子：
2.3
通讯作者：
Patton, JA
中科院分区：
文献类型：
--
作者：
Sehgal, CM;Arger, PH;Patton, JA
通过彩色和能量多普勒成像对七十四个活检证实的乳腺肿块进行成像，以评估恶性和良性乳腺肿块的血管模式。分析图像的血管分布。测量是在整个肿块以及其核心、外围和周围组织的局部区域进行的。分析手术标本的微血管密度。通过接受者操作特征分析评估多普勒超声血管分布指数的诊断性能。恶性肿块的血管比良性肿块多 14% 至 54%。通过超声检查，两种类型的肿块都比周围的组织有更多的血管。良性肿块的血管数量是周围组织的 2.2 倍，而恶性肿块的血管数量是周围组织的 5.0 倍。在一部分患者中，多普勒成像显示核心、外周和周围组织的区域血管分布与相应的组织学微血管密度测量值具有很强的相关性（R-2 > 0.9）。尽管恶性肿块在血管分布、核心、外围、周围组织上表现出较强的梯度，但良性肿块的血管分布相对均匀。多普勒指数的接收器操作特征曲线下面积 (A(z)) 范围为 0.56 +/- 0.07 至 0.65 +/- 0.07。包括年龄特定的多普勒指数值的非线性分析将诊断性能提高到 A(z) = 0.85 +/- 0.06。总之，定量多普勒成像与基于非线性规则的方法结合使用时，具有区分恶性和良性肿块的潜力。
Seventy-four biopsy proven breast masses were imaged by color and power Doppler imaging to evaluate vascular pattern of malignant and benign breast masses. The images were analyzed for vascularity. The measurements were made over the entire mass as well as regionally at its core, at its periphery, and in the tissue surrounding it. The surgical specimens were analyzed for microvessel density. The diagnostic performance of Doppler sonographic vascularity indices was evaluated by receiver operating characteristic analysis. The malignant masses were 14 to 54% more vascular than the benign masses. Both types of masses were more vascular by ultrasonography than the tissue surrounding them. Whereas benign masses were 2.2 times more vascular than the surrounding tissue, the malignant masses were 5.0 times more vascular. In a subset of patients the regional vascularity at the core, periphery, and surrounding tissue by Doppler imaging exhibited a strong correlation (R-2 > 0.9) with the corresponding histologic microvessel density measurements. Although the malignant masses exhibited a strong gradient in vascularity, core, periphery, surrounding tissue, the benign masses had relatively uniform distribution of vascularity. The area under the receiver operating characteristic curve (A(z)) for the Doppler indices ranged from 0.56 +/- 0.07 to 0.65 +/- 0.07. A nonlinear analysis including age-specific values of Doppler indices improved the diagnostic performance to A(z) = 0.85 +/- 0.06. In conclusion, quantitative Doppler imaging when used in combination with a nonlinear rule-based approach has the potential for differentiating between malignant and benign masses.