乳腺“第二眼”超声对动态增强MRI额外检出ACR-BI-RADS 4类以上病灶的再评价  

Re-evaluation of ACR-BI-RADS 4 or above of additional lesions seen by dynamic contrast-enhanced MRI by breast "second-look”ultrasound

作　　者：陈铃[1] 郭俊[1] 张建兴[1] 宋光辉[1] 潘曦阳 袁钰妍 CHEN Ling;GUO Jun;ZHANG Jianxing;SONG Guanghui;PAN Xiyang;YUAN Yuyan(Department of Ultrasound Imaging/Breast Diagnosis Center,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广东省中医院超声影像科/乳腺诊断中心,广州510120

出　　处：《实用医学杂志》2020年第15期2147-2151,共5页The Journal of Practical Medicine

基　　金：广东省医学科研基金项目(编号:B2018182,B2013170)。

摘　　要：目的探讨乳腺"第二眼"超声对动态增强MRI BI-RADS 4类以上额外检出的病灶再评价的临床价值。方法对术前乳腺动态增强MRI额外发现的ACR BI-RADS 4类以上的病灶,应用"第二眼"超声再评价的80例病灶进行回顾性分析。结果动态增强MRI额外检出的80个病灶中,77个病灶被"第二眼"超声检出,检出率为98.25%。动态增强MRI诊断乳腺癌的灵敏度77.4%,特异度70.4%,总符合率:75%;"第二眼"超声诊断乳腺癌的灵敏度78.4%,特异性92.3%,总符合率83%。"第二眼"超声与病理的一致性较好(Kappa=0.65,P <0.001),与增强MRI的一致性中等(Kappa=0.44,P <0.001);动态增强MRI与病理的一致性中等(Kappa=0.46,P <0.001)。结论动态增强MRI导向"第二眼"超声对乳腺癌的检出率及特异性较高。Objective To explore the clinical value of breast "second-look" ultrasound in the re-evaluation of additional lesions seen by dynamic contrast-enhanced MRI BI-RADS 4 or above.Methods A retrospective analysis was performed on 80 cases of ACR BI-RADS 4 or above additional lesions seen in preoperative breast enhancement contrast MRI.Results Among the 80 additional lesions seen by dynamic contrast enhanced MRI,77 lesions were detected by the "second-look" ultrasound,and the detection rate was 98.25%.The sensitivity of dynamic enhanced MRI in the diagnosis of breast cancer was 77.4%,the specificity was 70.4%,and the total coincidence rate was 75%.The sensitivity of the "second-look" ultrasound diagnosis of breast cancer was 78.4%,the specificity was 92.3%,the total coincidence rate was 83%.The "second-look" ultrasound showed good consistency with pathology(Kappa=0.65,P <0.001),and moderate consistency with enhanced MRI(Kappa=0.44,P<0.001);the consistency between dynamic enhanced MRI and pathology was moderate(Kappa=0.46,P <0.001).Conclusion Dynamic enhanced MRI-guided "second-look" ultrasound has a higher detection rate and specificity for breast cancer.

关 键 词：乳腺影像报告与数据系统 乳腺增强MRI 乳腺癌 “第二眼”超声 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]