CAJ | 학술논문

目的：探讨三维血流直方图定量分析在乳腺良恶性肿块内及周边血供评价中的应用价值。方法根据手术病理结果将165例乳腺肿块患者分成恶性组93例，良性组72例。所有患者术前行三维超声检查，采用血流直方图定量分析肿块内及周边3 mm的体积（ V）、血管指数（ VI）、血流指数（ FI）和血管血流指数（ VFI），肿块内指标用V-in、VI-in、FI-in、VFI-in表示；肿块周边3 mm指标用V-out、VI-out、FI-out和VFI-out表示。将恶性组和良性组肿块的血流定量参数结果进行统计学比较。结果乳腺肿块恶性组的VI-in、VFI-in、VI-out、FI-out及VFI-out测值均显著高于良性组（P＜0.05），V-in、V-out及FI-in两组间测值均未见明显统计学差异（P＞0.05）。 ROC曲线分析显示，在有效的诊断指标中以VI-out诊断效能最高，VI-in、VFI-in、VFI-out次之，FI-out最差。结论三维血流直方图定量分析能有效评估乳腺肿块内及周边血供情况。乳腺周边3 mm 的血流定量参数在乳腺良恶性肿块的鉴别诊断中具有一定的应用价值。
목적：탐토삼유혈류직방도정량분석재유선량악성종괴내급주변혈공평개중적응용개치。방법근거수술병리결과장165례유선종괴환자분성악성조93례，량성조72례。소유환자술전행삼유초성검사，채용혈류직방도정량분석종괴내급주변3 mm적체적（ V）、혈관지수（ VI）、혈류지수（ FI）화혈관혈류지수（ VFI），종괴내지표용V-in、VI-in、FI-in、VFI-in표시；종괴주변3 mm지표용V-out、VI-out、FI-out화VFI-out표시。장악성조화량성조종괴적혈류정량삼수결과진행통계학비교。결과유선종괴악성조적VI-in、VFI-in、VI-out、FI-out급VFI-out측치균현저고우량성조（P＜0.05），V-in、V-out급FI-in량조간측치균미견명현통계학차이（P＞0.05）。 ROC곡선분석현시，재유효적진단지표중이VI-out진단효능최고，VI-in、VFI-in、VFI-out차지，FI-out최차。결론삼유혈류직방도정량분석능유효평고유선종괴내급주변혈공정황。유선주변3 mm 적혈류정량삼수재유선량악성종괴적감별진단중구유일정적응용개치。
Objective To evaluate the distribution of vessels inside and adjacent to lesion region at three -dimensionalcolor histogram can be used for the differentiation of benign and malignant breast lesions .Methods Onehundred sixty five patients with breast lesions were divided into malignant lesion group (n =93) and benign lesiongroup(n =72), according to pathological findings .All cases underwent three-dimensional ultrasound exam.Threedimensionalcolor histogram was used to assess the volume and breast lesion indexes inside and outside 3 mm region,which included vascularization index(VI), flow index(FI)and vascularization-flow index(VFI ).Vascularity indexesinside were expressed respectively as V-in, VI-in, FI-in and VFI-in, and those outside surrounding region of 3 mmwere expressed respectively as V-out, VI-out, FI-out and VFI-out.All the results were compared between malignantlesion group and benign lesion group .Results VI-in, VFI-in, VI-out, FI-out and VFI-out in malignant lesion groupwere significantly higher than those in benign lesion group (P <0.05).The indices of V-in, V-out and FI-in in thetwo groups had no significant differences (P >0.05).Based on the receiver operating characteristic (ROC) curve,VI-out was the best index for the diagnosis of breast lesions .VI-in, VFI-in and VFI-out were the second one, and FIoutwas the last one.Conclusion The vascularity index of 3 mm surrounding region has certain value in the diagnosisof breast lesions.The quantitative analysis of three-dimensional color histogram has a certain value in assessing bloodflow inside and adjacent to breast lesions and improves the differential diagnosis of benign and malignant breast le -sions.