基于中国多中心研究数据的乳腺良恶性病灶超声造影定性特征的回顾性研究  

Qualitative Features of Contrast-enhanced Ultrasonography in Benign and Malignant Breast Lesions Based on Data of a Multi-center Study in China: A Retrospective Study

作　　者：沈若霞[1] 杨丽春[1] 罗晓茂[1] 年英华[1] 唐丽娜[2] 陈琴[3] 罗俊[3] 吕志红[4] 程印蓉[5] SHEN Ruoxia;YANG Lichun;LUO Xiaomao;NIAN Yinghua;TANG Lina;CHEN Qin;LUO Jun;LV Zhihong;CHENG Yinrong(Department of Ultrasound,Sichuan Provincial People’s Hospital,Chengdu 610072,China)

机构地区：[1]昆明医科大学第三附属医院(云南省肿瘤医院超声科),云南昆明650118 [2]福建省肿瘤医院超声科,福建福州350014 [3]四川省人民医院超声科,四川成都610072 [4]黄石中心医院,湖北黄石435000 [5]成都市第一人民医院超声科,四川成都610071

出　　处：《中国医学影像学杂志》2018年第12期885-889,共5页Chinese Journal of Medical Imaging

基　　金：云南省教育厅科学研究基金(2015C046Y;2014C031Y);云南省科技厅昆明医科大学应用基础研究联合专项基金(2018FE001-245)

摘　　要：目的分析不同超声造影定性特征对乳腺病灶的诊断价值。资料与方法基于国内进行的乳腺结节超声造影多中心研究数据,回顾性分析2015年8月—2017年3月来自国内8家医院的有效病例1074个乳腺病灶,并以病理诊断结果为"金标准",定性分析乳腺病灶超声造影各项参数特征,包括增强时相、增强强度、增强顺序、增强后病灶的形态、增强后病灶的边缘、增强后病灶范围、增强均匀性、增强后充盈缺损、蟹足征以及滋养血管。比较乳腺良、恶性病灶的超声造影特征;对照病理结果,对10项乳腺病灶超声造影特征进行二分类的Logistic回归分析,得出与病理结果最为相关的超声造影特征。结果良、恶性病灶的超声造影特征除增强顺序外,其余9项超声特征差异均有统计学意义(P<0.05)。Logistic回归分析显示,最后进入模型的5个参数分别为增强强度、增强后病灶范围、增强均匀性、增强后病灶形态及蟹足征,与乳腺恶性病灶有较高的相关性(P<0.05)。结论乳腺病灶的超声造影特征对乳腺良、恶性病灶的鉴别诊断具有应用价值。Purpose To analyze the diagnostic value of different qualitative characteristics of contrast-enhanced ultrasonography(CEUS)for benign and malignant breast lesions.Materials and Methods Based on the breast CEUS data of a multi-center study in China,a total of1074breast lesions from8domestic hospitals from August2015to March2017were retrospectively analyzed.With pathological diagnosis results as the gold standard,various CEUS parameters of breast lesions were evaluated,including enhancement phase,enhancement intensity,enhancement sequence,enhanced lesion morphology,enhanced lesion edge,enhanced lesion range,enhancement homogeneity,enhanced filling defect,crab claw-like enhancement pattern and vasa vasorum.The CEUS characteristics of benign and malignant breast lesions were analyzed;meanwhile,binary logistic regression analysis was performed for the10parameters referenced to corresponding pathological results to obtain the features with higher correlation.Results There were statistically significant differences in all CEUS features between benign and malignant lesions(P<0.05)except for enhancement sequence.Logistic regression analysis showed that the last5paraments enrolled in the model were enhancement intensity,enhanced lesion range,enhancement homogeneity,enhanced lesion morphology and crab claw-like enhancement pattern,which had higher correlation with breast carcinoma(P<0.05).Conclusion The CEUS features play an important role in the diagnosis and differential diagnosis of benign and malignant breast lesions.

关 键 词：乳腺肿瘤 超声检查 乳房 造影剂 诊断 鉴别 中国 多中心研究 

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]