常规超声联合弹性成像及造影鉴别诊断三阴性乳腺癌的价值  

Value of Conventional Ultrasound Combined with STE and CEUS in Differential Diagnosis of Triple Negative Negative Breast Cancer

作　　者：陈雪琴[1] 蔡敏娴[1] 汤晓晖 廖伟增[1] 卢彩成 陈祥[1] 李拾林[2] Chen Xueqin;Cai Minxian;Tang Xiaohui;Liao Weizeng;LU Caicheng;Chen Xiang;Li Shilin(Department of Ultrasound,The Second Hospital of Longyan City,Longyan,Fujian 364000;Department of Ultrasound Medicine,The Second Affiliated Hospital of Fujian Medical University,Quanzhou,Fujian 362000)

机构地区：[1]龙岩市第二医院超声科,福建龙岩364000 [2]福建医科大学附属第二医院超声医学科,福建泉州362000

出　　处：《现代医用影像学》2023年第8期1408-1412,1421,共6页Modern Medical Imageology

基　　金：福建省卫生健康青年科研课题,项目编号:2020QNB054。

摘　　要：目的:探讨三阴性乳腺癌(TNBC)与非三阴性乳腺癌(NTNBC)在常规超声、声触弹性成像(sound touch elastography,STE)、超声造影(contrast enhanced ultrasound,CEUS)的征象有无差异,以及利用常规超声联合STE及CEUS鉴别诊断三阴性乳腺癌的临床应用价值。方法:回顾性分析乳腺癌患者92例,术前均行常规超声、STE和CEUS检查,根据术后病理免疫组织化学结果将患者分为TNBC组23例和NTNBC组69例。比较二组患者乳腺肿块的常规超声、STE、CEUS的影像特征有无差异,并选取有差异的影像特征给予评分,以免疫组化结果为金标准,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)。结果:两组患者常规超声中肿块的边缘、微钙化、后方回声变化、高回声晕的差异有统计学意义;两组患者乳腺肿块STE弹性模量平均值、最大值、最小值的差异有统计学意义;两组患者CEUS在增强强度、增强后边界、增强后范围及灌注缺损的差异有统计学意义。AUC比较:三者联合(0.960)>超声造影(0.878)>常规超声(0.876)>弹性成像(0.669)。结论:三阴性乳腺癌与非三阴性乳腺癌在常规超声、STE、CEUS的部分征象有差异,三者联合诊断三阴性乳腺癌有较高的临床应用价值。Objective:To investigate whether the signs of triple-negative breast cancer(TNBC)are different from those of non-triple-negative breast cancer(NTNBC)in conventional ultrasound,sound touch elastography(STE)and contrast enhanced ultrasound(CEUS).The clinical application value of conventional ultrasound combined with STEand CEUS in the dfferential diagnosis of triple negative breast cancer was investigated.Methods:A retrospective analysis was conducted on 92 patients with breast cancer who underwent routine ultrasonography,STE and CEUS examinations before surgery.The patients were divided into a TNBC group(23 cases)and a NTNBC group(69 cases)according to pathological immunohistochemical results after surgery.The imaging features of conventional ultrasound,STE and CEUS were compared between the two groups,and the imaging features with differences were selected and scored.The results of immunohistochemistry were used as the gold standard to draw receiver operating characteristic(ROC)curve,and the area under the curve(AUC)was calculationed.Results:There were significant differences in the margin,microcalcification posterior echo and high echo halo between the two groups.The mean,maximum and minimum values of STE elastic modulus of breast mass were significantly different between the two groups.There were statistically significant differences in the intensity of enhancement,post-enhancement boundary,post-enhancement range and perfusion defect of CEUS between the two groups.Comparison of AUC:combination(0.960)>contrast-enhanced ultrasound(0.878)>conventional ultrasound(0.876)>elastic imaging(0.669).Conclusion:There are some differences between TNBC and NTNBC in routine ultrasound,STE and CEUS.The combined diagnosis of triple negative breast cancer has high clinical application value.

关 键 词：三阴性乳腺癌 声触弹性成像 超声造影 常规超声 

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]