剪切波弹性成像和超声造影联合评分鉴别不同大小BI-RADS 4类乳腺肿块良恶性的临床价值  

Clinical value of the combined score of shear wave elastography and contrast-enhanced ultrasound in differentiating benign and malignant BI-RADS 4 breast masses with different size

作　　者：沈倩倩 刘晓芳[2] 任志翔 贺红霞 郝如意 陈武[2] SHEN Qianqian;LIU Xiaofang;REN Zhixiang;HE Hongxia;HAO Ruyi;CHEN Wu(School of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学医学影像学院,太原市030001 [2]山西医科大学第一医院超声科 [3]山西省肿瘤医院超声科 [4]山西省儿童医院超声科

出　　处：《临床超声医学杂志》2022年第7期521-526,共6页Journal of Clinical Ultrasound in Medicine

基　　金：山西省卫生健康委科研课题(2019037)。

摘　　要：目的探讨剪切波弹性成像(SWE)和超声造影(CEUS)联合评分对不同大小乳腺影像报告和数据系统(BI-RADS)4类乳腺肿块良恶性的鉴别诊断价值。方法收集我院经常规超声诊断为BI-RADS 4类乳腺肿块患者158例(共167个肿块),均行SWE和CEUS检查,对每个肿块进行SWE、CEUS单独和联合赋值评分。以病理结果为金标准,绘制受试者工作特征(ROC)曲线分析SWE、CEUS单独及联合评分鉴别诊断不同大小BI-RADS 4类乳腺肿块良恶性的效能。结果①对于最大径>20 mm的BI-RADS 4类乳腺肿块,单独SWE与单独CEUS评分的敏感性、特异性、准确率、阳性预测值、阴性预测值和ROC曲线下面积(AUC)比较,差异均无统计学意义;联合评分的特异性高于单独SWE评分,准确率、阳性预测值、阴性预测值、AUC均高于单独SWE和CEUS评分,差异均有统计学意义(均P<0.05)。②对于最大径≤20 mm的BI-RADS 4类乳腺肿块,单独SWE与单独CEUS评分的敏感性、特异性、准确率、阳性预测值、阴性预测值和AUC比较,差异均无统计学意义;联合评分的敏感性、特异性、准确率、阳性预测值、阴性预测值和AUC均高于单独SWE和CEUS评分,差异均有统计学意义(均P<0.05)。结论SWE和CEUS联合评分对不同大小BI-RADS 4类乳腺肿块良恶性具有较高的鉴别诊断价值,特别是对于最大径≤20 mm的肿块诊断效能更佳,可减少不必要的穿刺活检。Objective To explore the diagnostic value of the combined score of shear wave elastography(SWE)and contrast-enhanced ultrasound(CEUS)in differentiating benign and malignant BI-RADS 4 breast masses with different size.Methods A total of 158 patients(167 masses)diagnosed as breast imaging reporting and data system(BI-RADS 4)breast masses by conventional ultrasound in our hospital were collected,and all patients underwent SWE and CEUS examinations.Each mass was scored by SWE and CEUS alone and in combination.Taking the pathological results as golden standard,the receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of SWE and CEUS alone and in combination in differentiating benign and malignant BI-RADS 4 breast masses with different size.Results①For the BI-RADS 4 breast masses with the maximum diameter>20 mm,there were no significant differences in diagnostic sensitivity,specificity,accuracy,positive predictive value,negative predictive value and the area under the ROC curve(AUC)between SWE score alone and CEUS score alone.The diagnostic specificity of the combined score was higher than that of SWE score alone,the diagnostic accuracy,positive predictive value,negative predictive value and the AUC of the combined score were higher than those of SWE score alone and CEUS score alone,and the differences were statistically significant(all P<0.05).②For the BI-RADS 4 breast masses with the maximum diameter≤20 mm,there were no significant differences in diagnostic sensitivity,specificity,accuracy,positive predictive value,negative predictive value and the AUC between SWE score alone and CEUS score alone.The diagnostic sensitivity,specificity,accuracy,positive predictive value,negative predictive value and the AUC of the combined score were higher than those of SWE score alone and CEUS score alone,and the differences were statistically significant(all P<0.05).Conclusion The combined score of SWE and CEUS has high diagnostic value in differentiating benign and malignant BIRADS 4 breast

关 键 词：超声检查 造影剂 弹性成像 剪切波 乳腺肿瘤 良恶性 乳腺影像报告和数据系统 

分 类 号：R445.1[医药卫生—影像医学与核医学]