目的：初步探讨超声造影时间-强度曲线（TIC）在三阴性乳腺癌（TNBC）鉴别诊断中的应用价值。方法：以病理及免疫组化结果为金标准，分析126例患者共126个病灶及其周围组织的超声造影TIC。结果：TNBC病灶增强强度及曲线下面积均大于非TNBC（P＜0.001），其ROC曲线下面积分别为0.857，0.807，初步界定当病灶增强强度＞11.99时，其为TNBC可能性大（灵敏度88%，特异度80%）,当病灶曲线下面积＞684.31时，其为TNBC可能性大（灵敏度60%，特异度95%）；TNBC组周围组织与非TNBC组周围组织对比，其基础强度较低，增强强度较大（P＜0.05）；与周围组织比较，TNBC组病灶的峰值强度、增强强度、上升支斜率、峰值减半差值时间、曲线下面积大于周围组织，两两比较有统计学差异（P<0.05），但不同于非TNBC，其始增时间、达峰时间、基础强度与周围组织比较无明显差异。结论：应用TIC定量分析可在一定程度上帮助鉴别TNBC与非TNBC。
Abstract
Objective: To explore the value of time-intensity curve(TIC) of contrast-enhanced in differentiation of triple-negative breast cancer(TNBC). Methods: TIC analysis were performed in 126 patients with 126 breast lesions and its surrounding tissue. Pathology and immunohistochemical staining used as the golden diagnostic criteria. Results: Contrast intensity and area under curve of TNBC lesions were larger than that of non-TNBC(P<0.001). And their area under the ROC curve was 0.857 and 0.807 respectively. We considered that when the parameter of contrast intensity>11.99, the lesions are prone to be TNBC(sensitivity 88%, specificity 80%), when the parameter of area under curve>684.31, the lesions are prone to be TNBC(sensitivity 60%, specificity 95%). The base intensity of surrounding tissue in TNBC group was lower, and the contrast intensity was larger, while comparing with the surrounding tissue in non-TNBC group. Compared with the surrounding tissue, the peak intensity, contrast intensity, ascending slope and half time of the lesions in the TNBC group were significantly higher than those in the surrounding tissue(P<0.05). With the different from non-TNBC, there was no significant difference in the arrive time, peak time and base intensity compared with the surrounding tissues. Conclusion: The quantitative analysis of TIC can help to differentiate TNBC from non-TNBC to a certain extent.
关键词
乳腺肿瘤 /
超声检查 /
多普勒 /
彩色 /
诊断 /
鉴别
Key words
Breast neoplasms /
Ultrasonography, Doppler, color /
Diagnosis, differential
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参考文献
[1]中华医学会神经病学分会脑血管病学组缺血性脑卒中二级预防指南撰写组. 中国缺血性脑卒中和短暂性脑缺血发作二级预防指南（2010）[J]． 中国临床医生，2011，39（11）：68-74．
[2]Schaller B, Graf R. Cerebral ischemia and reperfusion: the pathophysiologic concept as a basis for clinical therapy[J]. J Cereb Blood Flow Metab, 2004, 24(4): 351-371.
[3]Haacke EM, Xu Y, Cheng YC, et al. Susceptibility weighted imaging(SWI)[J]. Magn Reson Med, 2004, 52(3): 612-618.
[4]Davalos A, Castillo J, Alvarez-Sabin J, et al. Oral citicoline in acute ischemic stroke: an individual patient data pooling analysis of clinical trials[J]. Stroke, 2002, 33(12): 2850-2857.
[5]中华医学会． 脑卒中患者临床神经功能缺损程度评分标准（1995）[J]． 中华神经科杂志，1995，29（6）：62-64．
[6]Flacke S, Urbach H, Keller E, et al. Middle cerebral artery(MCA) susceptibility sign at susceptibility-based perfusion MR imaging: clinical importance and comparison with hyperdense MCA sign at CT[J]. Radiology, 2000, 215(2): 476-482.
[7]Rovira A, Orellana P, Alvarez-Sabin J, et al. Hyperacute ischemic stroke: middle cerebral artery susceptibility sign at echo-planar gradient-echo MR imaging[J]. Radiology, 2004, 232(2): 466-473.
[8]Liebeskind DS, Sanossian N, Yong WH, et al. CT and MRI early vessel signs reflect clot composition in acute stroke[J]. Stroke, 2011, 42(5): 1237-1243.
[9]Lingegowda D, Thomas B, Vaghela V, et al. “Susceptibility sign” on susceptibility-weighted imaging in acute ischemic stroke[J]. Neurol India, 2012, 60(2): 160-164.
[10]杨志宏，伍建林． 磁敏感加权成像在显示脑梗死血栓中的临床应用价值[J]． 中国临床医学影像杂志，2011，22（12）：837-839．
[11]佘德君. 磁敏感加权成像诊断脑梗死颅内动脉血栓的临床应用价值[D]. 福州：福建医科大学，2013.
[12]Schellinger PD, Chalela JA, Kang DW, et al. Diagnostic and prognostic value of early MR Imaging vessel signs in hyperacute stroke patients imaged <3 hours and treated with recombinant tissue plasminogen activator[J]. AJNR, 2005, 26(3): 618-624.
基金
广西科学研究与技术开发计划项目（No.桂科攻14124004-1-13）；广西医药卫生自筹经费计划课题（No.Z2016585）。
