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[特发性肉芽肿性乳腺炎与浸润性导管癌超声鉴别诊断的多因素分析]

[Multi-variated analysis of differential diagnosis in ultrasonography of idiopathic granulomatous mastitis and invasive ductal carcinoma].

作者信息

Yao C, Chen L L, Li Y P, Peng C Z, Li M K, Yao J

机构信息

Department of Ultrasound, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou 310007, China.

Department of Ultrasound, Zhejiang Xiaoshan Hospital, Hangzhou 311202, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2018 Mar 23;40(3):222-226. doi: 10.3760/cma.j.issn.0253-3766.2018.03.013.

DOI:10.3760/cma.j.issn.0253-3766.2018.03.013
PMID:29575844
Abstract

To evaluate the differential diagnosis of idiopathic granulomatous mastitis (IGM) and invasive ductal carcinoma. The ultrasonographic data of 37 IGM patients and 50 cases of IDC were analyzed retrospectively. The shape, growth direction, margin, internal echo, posterior echo, calcification, Adler blood flow classification, PSV(peak sestolic velocity), RI (resistance index)and elasticity scores were analyzed by (2) test and independent sample t test. The optimal cutoff values of age, PSV and RI were calculated by receiver operating characteristic (ROC) curve. Logistic regression analysis was used to calculate the odds ratio () of ultrasonic variates in the diagnosis of both diseases. There were no significant differences in the shape, margin, internal echo and blood flow grading between the two groups. The age, lesion growth direction, posterior echo, calcification, PSV, RI and elasticity were statistically different. The cut-of value of Age, PSV and RI were 38.5 years old, 13.20 cm/s, and 0.655. Logistic regression multi-variated analysis revealed that elastic score (=9.806) had the best value of the differential diagnosis, as well as calcification (=6.937), posterior echo decay (=4.613), RI (=3.257), lesion growth orientation (=3.198), and PSV (=1.202). Lesion shape, margin, internal echo, and Adler blood flow classification did not help in differential diagnosis. Ultrasound multi-parameter analysis has high value in IGM and IDC differential diagnosis.

摘要

评估特发性肉芽肿性乳腺炎(IGM)与浸润性导管癌的鉴别诊断。回顾性分析37例IGM患者和50例浸润性导管癌(IDC)患者的超声数据。通过卡方检验和独立样本t检验分析病灶的形态、生长方向、边界、内部回声、后方回声、钙化情况、Adler血流分级、收缩期峰值流速(PSV)、阻力指数(RI)及弹性评分。采用受试者工作特征(ROC)曲线计算年龄、PSV和RI的最佳截断值。运用Logistic回归分析计算超声变量在两种疾病诊断中的比值比(OR)。两组在形态、边界、内部回声及血流分级方面差异无统计学意义。年龄、病灶生长方向、后方回声、钙化情况、PSV、RI及弹性存在统计学差异。年龄、PSV和RI的截断值分别为38.5岁、13.20 cm/s和0.655。Logistic回归多变量分析显示,弹性评分(OR = 9.806)在鉴别诊断中价值最佳,其次为钙化(OR = 6.937)、后方回声衰减(OR = 4.613)、RI(OR = 3.257)、病灶生长方向(OR = 3.198)及PSV(OR = 1.202)。病灶形态、边界、内部回声及Adler血流分级对鉴别诊断无帮助。超声多参数分析在IGM与IDC的鉴别诊断中具有较高价值。

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