超声造影联合常规超声检查在乳腺病变(BI-RADS3-5类)诊断中的应用价值  

The diagnostic value of the combination of conventional ultrasound and contrast-enhanced ultrasound in breast lesions at BI-RADS 3-5 grade

作　　者：栗翠英[1] 林红军[1] 叶新华[1] 陈偲[2] 陈琳[2] 李奥[1] 汪惠宁[1] 孙小林[1] 

机构地区：[1]南京医科大学第一附属医院超声诊断科,江苏南京210029 [2]南京医科大学第一附属医院乳腺外科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2013年第9期1256-1260,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：南京医科大学第一附属医院新技术项目

摘　　要：目的:探讨超声造影(CEUS)联合常规超声(US)检查在乳腺病变(BI-RADS3-5类)诊断中的应用价值。方法 :采用常规超声及超声造影对99个乳腺病灶(BI-RADS 3-5)进行检查,分析乳腺病灶的增强模式、时间-强度曲线参数等指标,判定肿块的BI-RADS分类,以BI-RADS 4B判定恶性,并与术后病理结果进行比较。结果:术后病理良性58例,恶性41例,US诊断乳腺恶性病灶的敏感度100%,特异度55.17%,CEUS联合US诊断乳腺恶性病灶的敏感度97.56%,特异度91.23%。肿块内部血管走行紊乱、边缘见放射状增强、造影后范围增大等在良恶性间差异有意义(P<0.05),时间强度曲线参数(Peak、TTP、AUC)恶性与正常组织差值及良性与正常组织差值间差异有统计学意义,良恶性间仅Peak差异有统计学意义,而良性与正常组织间差异无统计学意义。结论:CEUS联合US检查对乳腺肿块的BI-RADS分类较单纯US更为准确,可更好地指导临床。Objective：To investigate the diagnostic value of the combination of conventional ultrasound （US） and contrast-enhanced ultrasound （CEUS） in breast lesions of BI-RADS 3-5 grade. Methods：Ninety-nine breast lesions were evaluated by using conventional US and CEUS. The pattern of contrast enhancement and the indexes of time-intensity curve were used to describe the lesions,which was also compared with pathological results. All lesions were classified by BI-RADS method and the malignant lesions ranked higher than BI-RADS 4B. Results：Sensitivity,specificity of US in the diagnosis of malignant breast lesions were： 100%,55.17%,respectively. While the combination of US and CEUS showed a sensitivity of 97.56 %,a specificity of 91.23%. Most malignant lesions displayed growing sizes,more vascularity and bending vascular shape after contrast. The difference value of Peak,TTP, and AUC showed a significant difference between benign lesion and normal tissue. Conclusion：Compared with conventional US,CEUS combined with conventional US may be more helpful for the BI-RADS classification of breast lesions.

关 键 词：超声造影 常规超声 乳腺 BI—RADS 

分 类 号：R445.1[医药卫生—影像医学与核医学]