BI-RADS 4B类乳腺肿块的超声造影诊断  

The Differential Diagnostic Value of Contrast-enhanced Ultrasonography in BI-RADSUS 4B Breast Lesions

作　　者：许萍[1] 黄淑演[1] 汪晓虹[1] 王怡[1] 

机构地区：[1]复旦大学附属华山医院超声医学科

出　　处：《中国医学计算机成像杂志》2013年第5期442-445,共4页Chinese Computed Medical Imaging

基　　金：上海市卫生局课题No.201005~~

摘　　要：目的:评价超声造影对常规超声BI-RADS 48类乳腺肿块的进一步鉴别诊断价值。方法:通过分析76个B1-RADS-US 4B类乳腺肿块的造影形态学特征和时间-强度曲线定量参数(AT、TTP、PI),进行超声造影良恶性鉴别诊断,并与术后病理结果进行对照。结果:76个BI-RADS-US 4B类肿块,术后病理结果为恶性47个、良性29个,良恶性组间在造影形态、边界、周围穿入或扭曲血管、内部对比剂分布、造影后有无显著增大方面均具有较显著差异(P<0.05),而定量参数AT、TTP、PI在良恶性组间均无明显差异(P>0.05)。76个BI-RADSUS 4B类肿块中造影诊断恶性51个、良性25个,其敏感性91.5%、特异性72.4%、阳性预测值84.3%、阴性预测值84.0%、准确性84.2%,其中主要是对浸润性导管癌、纤维腺瘤、导管原位癌的诊断准确性较高,分别为94.7%、91.7%、86.7%,反之对炎症的误诊率为100%。结论:超声造影可以对常规超声BI-RADS 4B类乳腺肿块做进一步良恶性鉴别,提高其术前诊断准确率。Purpose： To assess the value of contrast-enhanced ultrasonography （CEUS） in differential diagnosis of BI-RADS 4B breast lesions. Methods： The CEUS findings of 76 breast lesions of BI-RADS 4B, including morphologic features and time-intensity curve parameters（AT, TTP, PI） were analyzed, and in the end the CEUS diagnoses were made according to our preliminary study results. Histology results were served as golden reference. Results： Of all the 76 BI-RADS 4B breast lesions that were confirmed by histopathology results, 47 were malignant and 29 were benign. The differences of morphologic features of shape, margin, penetrating or tortuous surrounding vessels, heterogeneous or homogeneous distribution, whether the lesion was significant enlarged after contrast enhanced between benign and malignant lesions were with statistical significant （P〈0.05）. But the differences of the parameters （including AT, TTP, PI） between the benign and malignant lesions were with no statistical significant in our study （p〉0.05）. Fifty-one lesions were diagnosed as malignant, while 25 lesions were diagnosed as benign with CEUS. Its sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 91.5%, 72.4%, 84.3%, 84.0% and 84.2%. In all the histological types of these 76 breast lesions, the diagnostic accuracies for invasive ductal carcinoma, fibroadenoma and ductal carcinoma in situ were relatively higher, which were 94.7%, 91.7% and 86.7% respectively. For inflammatory lesions, the diagnostic accuracy was the lowest, and all of them were misdiagnosed. Conclusion： CEUS could be applied as a useful adjunct to conventional ultrasonography for BI-RADS 4B breast lesions. It can improve the diagnostic accuracy of breast lesions preoperatively.

关 键 词：乳腺疾病 乳腺影像报告和数据系统 超声造影 

分 类 号：R445.1[医药卫生—影像医学与核医学]