超声造影术前评价浸润性乳腺癌组织学分级的临床价值  

Value of Contrast-enhanced Ultrasound in the Preoperative Evaluation of Histological Grade of Invasive Breast Cancer

作　　者：李玲玲 苏荃利 林菲菲 邓芸霞 张尹俞 胡巧[1] Li Lingling;Su Quanli;Lin Feifei;Deng Yunxia;Zhang Yinyu;Hu Qiao(Department of Ultrasound,The People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院超声科,南宁市530021

出　　处：《中国超声医学杂志》2022年第12期1350-1354,共5页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金项目(No.82160339)。

摘　　要：目的 探讨超声造影(CEUS)特征术前评估浸润性乳腺癌组织学分级的应用价值。方法 回顾性分析病理确诊的乳腺癌患者138例不同病理分级组间超声造影定性指标及VueBox○R软件定量参数的差异,绘制受试者工作特征(ROC)曲线评价超声造影对乳腺癌组织学分级的诊断效能。结果 低级别组和高级别组乳腺癌患者的造影增强强度、均匀性、增强范围、灌注缺损、放射状增强等定性指标均存在显著差异(P<0.05),其中以不均匀增强和灌注缺损评估高级别乳腺癌的诊断效能最高,ROC曲线下面积分别为0.806和0.829。超声造影定量分析结果显示,高级别乳腺癌患者峰值强度(PE)、曲线下面积(AUC)、灌注比率(WiR)及流入相灌注指数(WiPI)明显高于低级别乳腺癌,组间差异有统计学意义(P<0.05),造影定量参数评价不同组织学分级乳腺癌具有较高诊断性能。结论 超声造影可无创性评价乳腺癌病理组织学分级,对临床治疗决策的确定具有指导作用。Objective To assess the efficacy of contrast-enhanced ultrasound(CEUS) in the preoperative evaluation of the histological grade of invasive breast cancer. Methods 138 patients with breast cancer confirmed by surgical pathology were included. The differences of qualitative indexes and quantitative parameters between different pathological grades were analyzed retrospectively. The receiver operating characteristic(ROC) curve was drawn to evaluate the diagnostic efficacy of CEUS for breast cancer at different histological grades. Results There were significant differences in contrast enhanced intensity, enhanced uniformity, enhanced range, perfusion defect and radial enhancement between low grade and high grade breast cancer groups(P<0.05). Ununiformed enhancement and perfusion defect had the highest diagnostic efficacy of high-grade breast cancer, with ROC area of 0.806 and 0.829, respectively. The peak enhancement(PE), area under the curve(AUC), wash-in rate(WiR) and wash-in perfusion index(WiPI) of high-grade breast cancer patients were significantly higher than those of low-grade breast cancer patients(P<0.05). The quantitative parameters of CEUS showed high diagnostic performance in different histological grades of breast cancer. Conclusions Contrast-enhanced ultrasound can noninvasively evaluate the histopathological grade of breast cancer, and has a guiding role in the selection of preoperative treatment.

关 键 词：超声造影 乳腺癌 组织学分级 

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]