超声造影联合超声弹性成像积分法对乳腺影像报告和数据系统3～4类乳腺肿物的诊断价值  

The value of contrast-enhanced ultrasound combined with ultrasound elastography scores in differential diagnosis of breast imaging reporting and data system 3-4 breast lesions

作　　者：徐玉桐 安婷婷[1] 张久维[1] 杨秀华[1] Xu Yutong;An Tingting;Zhang Jiuwei;Yang Xiuhua(Department of Abdominal Ultrasonography, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China)

机构地区：[1]哈尔滨医科大学第一临床医学院腹部超声科,150001

出　　处：《中华医学超声杂志（电子版）》2017年第10期766-770,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨超声造影积分法、超声弹性成像及二者联合积分法对乳腺影像报告和数据系统(BI-RADS)3~4类乳腺肿物的诊断价值。方法选取2015年10月至2016年3月在哈尔滨医科大学附属第一医院行常规超声检查,并依据BI-RADS分类,将定为3~4类的58例乳腺肿物患者(共60个病灶)行超声造影及超声弹性成像检查,依据相关观察指标给予评分,最终以手术病理结果为"金标准",采用受试者工作特征(ROC)曲线分别评估超声造影积分法、超声弹性成像及二者联合成像积分法对BI-RADS 3~4类乳腺肿物良、恶性鉴别诊断的价值。结果 60个乳腺病灶,病理结果显示良性29个,恶性31个。联合诊断积分法ROC曲线下面积为0.971,大于超声造影积分法及超声弹性成像单独诊断的ROC曲线下面积(分别为0.916及0.908)。联合诊断积分法的敏感度、特异度及准确性为87.1%、96.6%及92.0%;超声造影积分法诊断的敏感度、特异度及准确性为77.4%、93.1%及85.0%;超声弹性成像诊断的敏感度、特异度及准确性为74.2%、93.1%及83.3%。结论超声造影联合弹性成像积分法能进一步提高BI-RADS 3~4类乳腺肿物的良、恶性鉴别诊断效能。Objective To explore the value of contrast-enhanced ultrasound(CEUS)scores,ultrasonic elastography(UE)and their combined scores in diagnosing breast lesions of breast imaging reporting and data system(BI-RADS)3-4.Methods From October2015to March2016,60BI-RADS3-4solid breast masses diagnosed by conventional ultrasound underwent UE and CEUS.According to the relevant indicators,all cases were scored and proved by surgical pathology.The diagnostic sensitivity,specificity and accuracy of CEUS scores,UE and their combined scores were evaluated,and the receiver operating characteristic(ROC)curve was drawn.Results Twenty-nine benign and31malignant lesions were confirmed by pathology.The area under the ROC curve of CEUS combined with UE scores was0.971which was higher than that of CEUS Scores and UE alone(0.916and0.908,respectively).Moreover,the sensitivity,specificity and accuracy were87.1%,96.6%and92.0%for CEUS combined with UE Scores,77.4%,93.1%and85.0%for CEUS Scores,74.2%,93.1%and83.3%for UE,respectively.Conclusion CEUS combined with UE scores can improve the differetial diagnostic accuracy for BI-RADS3-4breast lesions.

关 键 词：乳腺肿物 超声弹性成像 超声造影 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]