Park A Y, Seo B K, Woo O H, Jung K S, Cho K R, Park E K, Cha S H, Cha J
Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Gyeonggi-do, Republic of Korea.
Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Gyeonggi-do, Republic of Korea.
Clin Radiol. 2018 Mar;73(3):304-311. doi: 10.1016/j.crad.2017.10.006. Epub 2017 Nov 6.
To investigate the utility of superb microvascular imaging (SMI) for evaluating the vascularity of breast masses in comparison with colour or power Doppler ultrasound (US) and the effect on diagnostic performance.
A total of 191 biopsy-proven masses (99 benign and 92 malignant) in 166 women with greyscale, colour Doppler, power Doppler, and SMI images were enrolled in this retrospective study. Three radiologists analysed the vascular images using a three-factor scoring system to evaluate the number, morphology, and distribution of tumour vessels. They assessed the Breast Imaging-Reporting and Data System categories for greyscale US alone and combinations of greyscale US and each type of vascular US. The Kruskal-Wallis test was performed and the area under the receiver-operating characteristic curve (AUC) measured. On SMI, vascular scores were compared between benign and malignant masses and the optimal cut-off value for the overall score was determined.
SMI showed higher vascular scores than colour or power Doppler US and malignant masses had higher scores than benign masses (p<0.001). The diagnostic performance of the combination of greyscale US and SMI was higher than those of greyscale US alone and greyscale and colour or power Doppler US (AUC, 0.815 versus 0.774, 0.789, 0.791; p<0.001). The optimal cut-off value of the overall vascular score was 5 with a sensitivity of 82.3% and a specificity of 65.3% (AUC, 0.808).
SMI is superior to colour or power Doppler US for characterising the vascularity in breast masses and improving diagnostic performance.
探讨与彩色或能量多普勒超声（US）相比，超微血管成像（SMI）在评估乳腺肿块血管方面的效用及其对诊断性能的影响。
本回顾性研究纳入了166名女性的191个经活检证实的肿块（99个良性和92个恶性），这些肿块均有灰阶、彩色多普勒、能量多普勒和SMI图像。三名放射科医生使用三因素评分系统分析血管图像，以评估肿瘤血管的数量、形态和分布。他们仅评估了灰阶US的乳腺影像报告和数据系统类别，以及灰阶US与每种血管US组合的类别。进行了Kruskal-Wallis检验并测量了受试者操作特征曲线（AUC）下的面积。在SMI上，比较了良性和恶性肿块的血管评分，并确定了总分的最佳截断值。
SMI显示的血管评分高于彩色或能量多普勒US，恶性肿块的评分高于良性肿块（p<0.001）。灰阶US与SMI组合的诊断性能高于单独的灰阶US以及灰阶与彩色或能量多普勒US的组合（AUC分别为0.815、0.774、0.789、0.791；p<0.001）。血管总分的最佳截断值为5，灵敏度为82.3%，特异性为65.3%（AUC为0.808）。
在表征乳腺肿块血管及提高诊断性能方面，SMI优于彩色或能量多普勒US。
