S-Detect联合超声造影对乳腺BI-RADS4类病灶的应用价值  

Application value of S-Detect combined with contrast-enhanced ultrasound in the Breast Imaging Reporting and Data System 4 breast lesions

作　　者：金金 何文[1] 于腾飞[1] 广旸 张红霞[1] 程令刚[1] 张巍[1] Jin Jin;He Wen;Yu Tengfei;Guang Yang;Zhang Hongxia;Cheng Linggang;Zhang Wei(Department of Ultrasound,Beijing Tiantan Hospital,Capital Medical University,Beijing 100071,China)

机构地区：[1]首都医科大学附属北京天坛医院超声科,北京100071

出　　处：《中华超声影像学杂志》2023年第5期392-398,共7页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(82102038)。

摘　　要：目的探讨S-Detect、超声造影(CEUS)对乳腺影像报告和数据系统(BI-RADS)4类乳腺病灶的鉴别诊断价值。方法前瞻性选取2021年1月至2022年4月于首都医科大学附属北京天坛医院经常规超声诊断为BI-RADS 4类的乳腺结节患者100例,共104个病灶,所有病灶同时接受S-Detect和CEUS检查,以病理结果为金标准,构建ROC曲线,比较常规超声、S-Detect、CEUS及联合应用对BI-RADS 4类乳腺病灶的诊断效能。结果104个乳腺BI-RADS 4类病灶中,病理结果证实为良性病灶63个,恶性病灶41个。常规超声、S-Detect、CEUS及联合应用诊断的敏感性分别为73.17%、87.80%、87.80%、90.24%,特异性分别57.14%、60.32%、68.25%、77.78%,阳性预测值分别为52.63%、59.02%、64.29%、72.55%,阴性预测值分别为76.60%、88.37%、89.59%、92.45%,准确性分别为63.46%、71.15%、75.96%、82.69%,ROC曲线下面积(AUC)分别为0.652、0.741、0.780、0.840。S-Detect及CEUS诊断的敏感性、特异性、阳性预测值、阴性预测值及准确性均较常规超声有所提高,联合诊断的AUC分别高于S-Detect、CEUS单独应用,差异有统计学意义(均P<0.05),CEUS的AUC高于常规超声,差异有统计学意义(P<0.05),其余组间两两比较差异无统计学意义(均P>0.05)。结论S-Detect和CEUS联合应用可以实现优势互补,对于乳腺BI-RADS 4类病灶良恶性的鉴别诊断具有重要意义。Objective To assess the value of S-Detect and contrast-enhanced ultrasound(CEUS)in the differential diagnosis of Breast Imaging Reporting and Data System(BI-RADS)4 breast lesions.Methods A total of 104 breast lesions in 100 patients diagnosed as BI-RADS category 4 by conventional ultrasound were prospectively enrolled,and all of them were received S-Detect and CEUS examination at the same time.Taking pathology as the gold standard,ROC curve was constructed to compare the diagnostic efficacy of conventional ultrasound,S-Detect,CEUS and their combination.Results Among the 104 BI-RADS category 4 breast lesions,63 were benign and 41 were malignant.The sensitivities of conventional ultrasound,S-Detect,CEUS and S-Detect combined with CEUS were 73.17%,87.80%,87.80%,90.24%;the specificities were 57.14%,60.32%,68.25%,77.78%;the positive predictive values were 52.63%,59.02%,64.29%and 72.55%;the negative predictive values were 76.60%,88.37%,89.59%and 92.45%;the accuracies were 63.46%,71.15%,75.96%and 82.69%;and the areas under the ROC curve(AUC)were 0.652,0.741,0.780 and 0.840.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of S-Detect and CEUS diagnosis were improved compared with conventional ultrasound.The AUC of combined diagnosis was higher than that of S-Detect,CEUS alone,and the differences were statistically significant(all P<0.05).The AUC of CEUS was higher than that of conventional ultrasound,and the difference was statistically significant(P<0.05).There were no significant differences in AUC between any two of other groups(all P>0.05).Conclusions The combined application of S-Detect and CEUS could achieve complementary advantages,which is of great significance for the differential diagnosis of benign and malignant in BI-RADS 4 breast lesions.

关 键 词：超声检查 S-Detect 超声造影 乳腺影像报告和数据系统 乳腺病灶 

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]