多模态超声成像评分法对非肿块型乳腺病变良恶性的鉴别诊断价值  

A Novel Multimodal Ultrasound Scoring Method for Differentiation of Benign and Malignant Non-mass-like Breast Lesions

作　　者：王伟[1] 赵丹[1] 兰晶[2] 王旭婕 詹晓丽 郑燕[1] 董凤林[1] Wang Wei;Zhao Dan;Lan Jing;Wang Xujie;Zhan Xiaoli;Zheng Yan;Dong Fenglin(Department of Ultrasound,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215000,China;Department of General Surgery,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州大学附属第一医院超声科,江苏省苏州市215000 [2]苏州大学附属第一医院普外科,江苏省苏州市215000

出　　处：《中国超声医学杂志》2022年第10期1097-1100,共4页Chinese Journal of Ultrasound in Medicine

基　　金：苏州市科学技术局民生科技关键技术应用研究项目(No.SS202062)。

摘　　要：目的 探讨多模态超声成像评分法对非肿块型乳腺病变(NMLs)良恶性的鉴别诊断价值。方法 回顾性分析103例NMLs患者的资料,所有病变均行常规超声(US)、弹性成像(SE)及超声造影(CEUS)检查。参考相关文献分别对US、SE及CEUS进行评分,不同方法评分相加得出联合诊断评分。构建US、US+SE、US+CEUS及US+SE+CEUS的ROC曲线并比较诊断效能。结果 US、US+SE、US+CEUS及US+SE+CEUS诊断NMLs良恶性的灵敏度、特异度、准确度及AUC分别为:75.0%、31.9%、55.3%、0.615;80.4%、68.1%、74.8%、0.767;98.2%、 55.3%、78.6%、0.837;78.6%、95.7%、86.4%、0.902。其中US+SE+CEUS的AUC最大(P<0.05),US+SE与US+CEUS的AUC均大于US(P<0.05),但两者之间差异无统计学意义(P>0.05)。US+CEUS的灵敏度最高(P<0.05),US+SE+CEUS的特异度最高(P<0.05)。结论 多模态超声成像评分法为NMLs良恶性的鉴别提供了一种实用、简单、有效的方法。Objective To evaluate the differential diagnosis value of a novel multimodal ultrasound scoring method in non-mass-like breast lesions(NMLs). Methods The medical data of 103 cases with NMLs were retrospectively analyzed. All breast lesions were examined by B-mode ultrasound(US), strain elastography(SE), and contrast-enhanced ultrasound(CEUS). US, SE and CEUS were scored by referring to relevant literatures and the scores of different methods were added to obtain the joint diagnostic scores. The receiver operating characteristic(ROC) curves of US, US+SE, US+CEUS, and US+SE+CEUS were plotted, and the diagnostic efficacy of these imaging methods was compared. Results The diagnostic sensitivity, specificity, diagnostic accuracy, and area under the curve(AUC) for differentiating benign and malignant NMLs using US, US+SE, US+CEUS, and US+SE+CEUS were(75.0%, 31.9%, 55.3%, 0.615),(80.4%, 68.1%, 74.8%, 0.767),(98.2%, 55.3%, 78.6%, 0.837), and(78.6%, 95.7%, 86.4%,0.902), respectively. The AUC value of US+SE+CEUS was the highest(P<0.05), and the AUC values of US+SE and US+CEUS were greater than that of the US(P<0.05), while there was no significant difference of the US+SE and US+CEUS methods(P>0.05). The highest sensitivity was belonged to US+CEUS(P<0.05). Besides, US+SE+CEUS achieved the highest specificity(P<0.05). Conclusions The multimodal ultrasound scoring method provides a practical, simple, and effective differentiation of benign and malignant NMLs.

关 键 词：非肿块型乳腺病变 多模态超声成像 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]