Blohmer J U, Oellinger H, Schmidt C, Hufnagl P, Felix R, Lichtenegger W
Department of Obstetrics and Gynecology, Medizinische Fakultät, Humboldt-Universität Berlin.
Arch Gynecol Obstet. 1999;262(3-4):159-71. doi: 10.1007/s004040050244.
Color Doppler sonography (CD) was compared with other diagnostic imaging methods [mammography (MG), breast ultrasound (US) and magnetic resonance imaging (MRI)] in the planning of surgery for breast tumors.
99 patients with breast cancer and 101 with ultimately benign breast lesions were examined preoperatively. The specificity and sensitivity were calculated, as well as the predictive values. Various qualitative and semiquantitative CD parameters were also analysed for their diagnostic value.
The sensitivity/specificity of the various methods (in %) was: MG 85/77; US 95/80; CD 82/75; MRI 90/63. The positive predictive value (ppv)/negative predictive value (npv) (in %) was: MG 79/83; US 81/94; CD 72/84; MRI 79/63. The median maximum systolic flow velocity and the resistance index (RI) were significantly higher in breast cancer vessels than in benign lesions. The number of pulsating color pixels detected by CD was significantly higher for breast cancer. In cases of breast cancer significantly more blood flows were detected in the body of the tumor than at its periphery.
Color Doppler sonography was not superior to other diagnostic methods for preoperative assessment of a breast lesion. The combination of all diagnostic procedures gave a correct classification rate of 93.3% and is much better than the correct classification of any single diagnostic imaging procedure.
在乳腺肿瘤手术规划中，对彩色多普勒超声（CD）与其他诊断成像方法[乳腺X线摄影（MG）、乳腺超声（US）和磁共振成像（MRI）]进行比较。
对99例乳腺癌患者和101例最终诊断为良性乳腺病变的患者进行术前检查。计算特异性、敏感性以及预测值。还分析了各种定性和半定量CD参数的诊断价值。
各种方法的敏感性/特异性（%）为：MG 85/77；US 95/80；CD 82/75；MRI 90/63。阳性预测值（ppv）/阴性预测值（npv）（%）为：MG 79/83；US 81/94；CD 72/84；MRI 79/63。乳腺癌血管中的最大收缩期血流速度中位数和阻力指数（RI）显著高于良性病变。CD检测到的搏动性彩色像素数量在乳腺癌中显著更高。在乳腺癌病例中，肿瘤主体内检测到的血流明显多于肿瘤周边。
彩色多普勒超声在术前评估乳腺病变方面并不优于其他诊断方法。所有诊断程序联合使用的正确分类率为93.3%，远高于任何单一诊断成像程序的正确分类率。
