Zonderland H M, Hermans J, Coerkamp E G
Department of Radiology, Leiden University Medical Center, The Netherlands.
Eur Radiol. 2000;10(10):1562-8. doi: 10.1007/s003300000585.
In a prospective two-centre study targeted US was performed as an adjunct to mammography in a population of 1103 patients with 272 breast cancers, 517 benign lesions and no abnormalities in 314 patients. The purpose of the study was to analyse the distribution of the different US variables among the breast lesions and to determine the prognostic value of these variables with respect to the diagnosis of malignancy. The following variables were analysed: border; contour; orientation; structure; echogenicity; sound transmission; and size. These variables were correlated with the definitive diagnosis and univariate analysis was performed. A statistically significant association with breast cancer (p < 0.001) was present for irregular border; ill-defined contour; indeterminate or vertical orientation; homogeneous, complex or heterogeneous structure; hypoechogenicity; and unchanged or decreased sound transmission. Multivariate analysis showed a high independent prognostic value for malignancy for irregular border, followed by ill-defined contour and unchanged or decreased sound transmission. However, their discriminative power was not absolute: in 38 cancers none of the malignant US variables were present, and in 11 benign lesions all variables were present. There were hardly any benign-looking lesions that proved to be malignant.
在一项前瞻性双中心研究中，对1103例患者进行了靶向超声检查，作为乳腺钼靶检查的辅助手段，其中有272例乳腺癌、517例良性病变，314例患者无异常。该研究的目的是分析不同超声变量在乳腺病变中的分布情况，并确定这些变量对恶性肿瘤诊断的预后价值。分析了以下变量：边界；轮廓；方向；结构；回声性；声传播；以及大小。将这些变量与最终诊断相关联并进行单变量分析。不规则边界、轮廓不清、不确定或垂直方向、均匀、复杂或不均匀结构、低回声性以及声传播不变或降低与乳腺癌存在统计学显著关联（p < 0.001）。多变量分析显示，不规则边界对恶性肿瘤具有较高的独立预后价值，其次是轮廓不清以及声传播不变或降低。然而，它们的鉴别能力并非绝对：在38例癌症中，没有出现任何恶性超声变量，而在11例良性病变中，所有变量均存在。几乎没有看似良性的病变被证明是恶性的。
