超声造影定性及定量分析对乳腺非肿块型病变的鉴别诊断价值  

Value of qualitative and quantitative analysis of contrast-enhanced ultrasound in differential diagnosis of non-mass lesions on breast ultrasound

作　　者：李冉 范会军 郭丽娟[1] 徐杰[1] 张凯[1] Li Ran;Fan Huijun;Guo Lijuan;Xu Jie;Zhang Kai(Deaprtment of Ultrasound,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China)

机构地区：[1]新乡医学院第一附属医院超声科,卫辉453100

出　　处：《中国实用医刊》2022年第11期84-87,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析超声造影定性及定量分析在乳腺非肿块型病变良恶性鉴别诊断中的价值。方法回顾性分析2019年1月至2021年9月新乡医学院第一附属医院收治的103例乳腺非肿块型病变患者的临床资料。患者均使用佳能i900彩色多普勒超声诊断仪行超声造影诊断和定性、定量分析, 以病理结果为"金标准", 比较超声造影定性分析和定量分析单独、联合的诊断结果及诊断效能, 比较两种方法单独和联合诊断的预测值和约登指数, 比较不同性质乳腺非肿块型病变患者的超声定性指标情况和定量参数[峰值强度(PI)、相对达峰强度、增强时间、达峰时间(TTP)、平均通过时间(MTT)]表达。结果 103例乳腺非肿块型病变患者, 病理结果证实恶性46例, 良性57例;超声造影定性分析检查出恶性32例, 良性43例;超声造影定量分析检查出恶性35例, 良性40例;超声造影定性联合定量分析检查出恶性42例, 良性53例。超声造影定性联合定量分析诊断的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于定性和定量分析单独诊断, 漏诊率、误诊率低于定性和定量分析单独诊断(P<0.05), 且联合诊断的约登指数更高。恶性和良性患者超声造影增强顺序和均匀性差异未见统计学意义(P>0.05), 但与良性患者相比, 恶性患者造影剂到达时间较早、消退时间同步或较晚, 且增强强度多表现为高增强(P<0.05)。恶性与良性患者超声造影定量TTP参数比较差异未见统计学意义(P>0.05), 但恶性患者PI、相对达峰强度、MTT参数高于良性患者, 增强时间参数低于良性患者(P<0.05)。结论超声造影定性及定量分析在乳腺非肿块型病变性质鉴别中效果显著, 准确度较高, 且恶性和良性病变患者在定性指标和定量参数方面存在显著差异, 可为临床诊断提供丰富影像学信息支持。Objective To analyze the value of qualitative and quantitative analysis of contrast-enhanced ultrasonography in the differential diagnosis of benign and malignant non-mass lesions on breast ultrasound.Methods The clinical data of 103 patients with non-mass lesions on breast ultrasound treated in the First Affiliated Hospital of Xinxiang Medical University from January 2019 to September 2021 were retrospectively analyzed.All patients underwent contrast-enhanced ultrasound diagnosis and qualitative and quantitative analysis with Canon i900 color Doppler ultrasound diagnostic instrument.Taking the pathological results as the gold standard,the diagnostic results and diagnostic efficacy of qualitative analysis of contrast-enhanced ultrasound,quantitative analysis of contrast-enhanced ultrasound,and combination of them were compared.The predicted values and Youden index of the two methods and combination of them were compared;the ultrasonic qualitative indexes and the expression of quantitative parameters,such as peak intensity(PI),relative peak intensity,enhancement time,time to peak(TTP),mean transit time(MTT)in patients with non-mass lesions on breast ultrasound were compared.Results Among 103 patients with non-mass lesions ultrasound,pathological results confirmed 46 patients with malignant lesions and 57 patients with benign lesions.Results of qualitative analysis of contrast-enhanced ultrasound showed 32 malignant cases and 43 benign cases;results of quantitative analysis of contrast-enhanced ultrasound showed 35 malignant cases and 40 benign cases;results of qualitative combined with quantitative analysis of contrast-enhanced ultrasound showed 42 malignant cases and 53 benign cases.The diagnostic sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of qualitative combined quantitative analysis of contrast-enhanced ultrasound were higher than those of single qualitative and quantitative analysis of contrast-enhanced ultrasound,and the missed diagnosis rate and misdiagnosis rate

关 键 词：乳腺癌 超声造影 定性参数 定量参数 

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]