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1、加速时间指数鉴别良、恶性乳腺肿物的临床研究【摘要】目的利用加速时间指数(accelerationtimeindex,ATI)鉴别乳腺癌及乳腺良性肿物,并通过受试者工作特征(receiveroperatingcharacteristic,ROC)曲线评价其可靠性。方法皿1=加速时间/心动周期。所检测血流样本均來自肿物内部，不包括周边的血流信号。以病理结果为标准。利用ROC曲线评估ATI的诊断价值。结杲106个病变中，良性67个(纤维腺瘤34个,乳腺增生26个，乳腺腺病7个),M39个(非浸润性癌24个,浸润性癌15个)。良性肿物的ATI值(0.06
2、4〜0.159,平均0.105)低于恶性肿物(0.084〜0.250,平均0.176)。对于乳腺良、恶性肿物,ATI差异有统计学意义(P<0.01)oROC曲线下面积为0.956,诊断价值高。以ATI=0.155作为授佳临界值具有较高的灵嫩度(90%)和特异度(99%)o结论ATI在鉴别乳腺良、恶性肿物方而具有极大优势。【关键词】加速时间指数；乳腺癌；乳腺良性肿物；多普勒超声；ROC曲线分析Theclinicalvaluesofaccelerationtimeindexforthedifferentiationbetweenbenignandma
3、lignantbreasttumorsYANGYi,LIUNing,WANGXiaoyan,etal.DepartmentofUltrasonography,HairisionInternationalPeaceHospital,Hebei,Hengshui053000,China【Abstract】ObjectiveTodeterminewhethertheaccelerationtimeindexcouldreliablydifferentiatebreasttumorswithreceiveroperatingcharacteristic(
4、ROC)curx^e.MethodsATI(accelerationtime/cardiaccycletime)wascalculatedfromintratumoralflow,excludingperipheralbloodflowsignal.Allthelesionswerebasedontheresultsofhistopathologicalorhistologicalanalyses.ATIwasevaluatedandcomparedbetweenthebenignandmalignantgroups.Thediagnosticv
5、alueofATIwasevaluatedbyusingROCcurve・ResultsAmong67breastbenigntumors,therewere34fibroadenoma,26hyperplasiaofmammaryglands,7sclerosingadenosis.In39malignantlesions,therewere24noninvasivecarcinomaJ5invasivecarcinoma.ThediagnosticvaluesofATIwerelowerinbenigntumors(ATI,mean,0.10
6、5;range,0.064〜0.159)thaninmalignanttumors(ATI,mean,0.176;range,0.084-0.250).However,thereweresignificantdifferencesintheATIvaluesbetweenbenignandmalignantgroups(P<0.01).TheareaunderROCcurvewas0.956anddiagnosticvaluewasbetter.AnATIvalueof0.155seemedtobetheoptimumthresholdforth
7、edifferentiationofbenignandmalignantlesions(90%sensitivity,99%specificityrespectively).ConclusionATIisthemostusefulparameterfordifferentiatingbenignbreasttumorsfrommalignantbreasttumors.[Keywords]accelerationtimeindex;breastcancer;breasttumors;Dopplerultrasonography;ROCanalys
8、is乳腺癌的早期诊断己有研究利用彩色多普勒血流动力学参数迹行半定量分析,比如收缩期流速峰值(PSV)、阻力指数(RI)及搏动指数(PI)
