【摘要】 目的 探讨彩色多普勒超声(color Doppler ultrasonography, CDU)联合弹性成像(ultrasonic elastography, UE)、高精细血流成像(Fine-Flow)在乳腺癌腋窝淋巴结转移诊断中的差异与价值。方法 选取2019年1月至2022年1月河北北方学院附属第二医院功能科收治的疑似乳腺癌腋窝淋巴结转移患者81例作研究对象，进行CDU、CDU+UE,CDU+Fine-Flow与CDU+UE+Fine-Flow检查，用Kappa系数评估这四种诊断方法诊断的一致性及敏感度、特异度、准确度、阳性预测值和阴性预测值。结果 CDU检查阳性例数为75例，CDU+UE检查阳性例数为70例，CDU+Fine-Flow检查阳性例数为70例，而在四项联合显示阳性例数64例，CDU、CDU+UE、CDU+Fine-Flow和CDU+UE+Fine-Flow的一致性分析依次为中度一致(Kappa=0.581,P<0.001)、高度一致(Kappa=0.733,P<0.001)、高度一致(Kappa=0.736,P<0.001)、几乎完全一致(Kappa=0.856,P<0.001),敏感度依次为83.78%、86.49%、90.54%、97.37%,准确率依次为76.54%、79.01%、95.71%、98.67%。CDU+UE+Fine-Flow的敏感度、特异度、准确率、阳性预测值、阴性预测值依次高于CDU+Fine-Flow、CDU+UE和CDU。结论 CDU+UE+Fine-Flow联合在乳腺癌腋窝淋巴结转移诊断中的价值较CDU+Fine-Flow、CDU+UE和单纯的CDU更高，应用前景较好。更多还原

【Abstract】 Objective To investigate the difference and the diagnostic value of color Doppler ultrasonography(CDU) combined with ultrasonic elastography(UE) and high-resolution ultrasonic imaging of blood flow(Fine-Flow) in diagnosing axillary lymph node metastasis of breast cancer. Methods From January 2019 to January 2022, 81 patients with suspected axillary lymph node metastasis of breast cancer admitted to the Department of Function, the Second Affiliated Hospital of Hebei North University were selected as the research objects. They were examined by CDU, CDU+UE, CDU+Fine-Flow and CDU+UE+Fine-Flow. Kappa coefficient was used to evaluate the consistency, sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the four diagnostic methods.Results There were 75, 70, 70 and 64 positive cases detected by CDU, CDU+UE, CDU+Fine-Flow and CDU+UE+Fine-Flow, respectively. The consistent analysis showed that CDU(Kappa=0.581,P<0.001), CDU+UE(Kappa=0.733,P<0.001), CDU+Fine-Flow(Kappa=0.736,P<0.001) and CDU+UE+Fine-Flow(Kappa=0.856,P<0.001) were assessed as moderate, substantial, substantial and almost perfect agreement, respectively. Their sensitivity was 83.78%, 86.49%, 90.54%, and 97.37%, respectively, and the accuracy was 76.54%, 79.01%, 95.71%, and 98.67%, respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CDU+UE+Fine-Flow were higher than those of CDU+Fine-Flow, CDU+UE and CDU sequentially. Conclusion The combination of CDU+UE+Fine-Flow is more valuable than CDU+Fine-Flow, CDU+UE and CDU alone in the diagnosis of axillary lymph node metastasis of breast cancer, showing a good application prospect.更多还原