常规超声联合超声造影在乳腺导管内乳头状瘤鉴别诊断中的应用价值  

Application Value of Conventional Ultrasound Combined with Contrast-Enhanced Ultrasound in the Differential Diagnosis of Breast Intraductal Papilloma

作　　者：董飒 贾海燕 杨尚洁 刘立平 DONG Sa;JIA Haiyan;YANG Shangjie;LIU Liping(Department of Ultrasound Intervention,The First Hospital of Shanxi Medical University,Taiyuan,Shanxi 030000,China)

机构地区：[1]山西医科大学第一医院超声介入科,山西太原030000 [2]山西省运城市中心医院超声科,山西运城044000

出　　处：《转化医学杂志》2024年第3期329-333,339,共6页Translational Medicine Journal

摘　　要：目的探讨常规超声联合超声造影(CEUS)对乳腺导管内乳头状瘤(IDP)和乳腺癌的鉴别诊断价值。方法选择2020年1月至2023年6月山西医科大学第一医院及山西省运城市中心医院收治的乳腺IDP患者53例(IDP组)和乳腺癌患者70例(乳腺癌组),2组均接受常规超声和CEUS检查,参照乳腺影像学报告和数据系统(BI-RADS)对病灶进行重新赋分、分级,即CEUS-BI-RADS分级。比较2组患者应用BI-RADS、CEUS-BI-RADS分级差异和CEUS影像特征,采用受试者工作特征(ROC)曲线分析常规超声联合CEUS对IDP与乳腺癌的鉴别诊断价值。结果IDP组与乳腺癌组应用BI-RADS、CEUS-BI-RADS分级差异有统计学意义(P<0.05),IDP组与乳腺癌组增强顺序、增强时相、增强后边界、增强后形态、增强范围增大占比、蟹足征占比比较差异均有统计学意义(P<0.05);BI-RADS分级鉴别IDP和乳腺癌的曲线下面积(AUC)值为0.783(95%CI:0.569~0.891),CEUS-BI-RADS分级鉴别IDP和乳腺癌的AUC值为0.914(95%CI:0.738~0.982),2种方法的诊断价值比较差异有统计学意义(P<0.05)。结论常规超声联合CEUS可提高IDP与乳腺癌的早期鉴别诊断的准确性,指导临床治疗,对于改善患者预后和生活质量具有积极意义。Objective To investigate the value of conventional ultrasound combined with contrast-enhanced ultrasound(CEUS)in the differential diagnosis of intraductal papilloma(IDP)and breast cancer.Methods 53 breast IDP patients(IDP group)and 70 patients with breast cancer(breast cancer group)were selected from The First Hospital of Shanxi Medical University and Yuncheng Central Hospital from January 2020 to June 2023.Both groups received conventional ultrasound and CEUS,and the lesions were reclassified by combining the characteristics of conventional ultrasound and CEUS according to the Breast Imaging-Reporting and Data System(BI-RADS),namely the CEUS-BI-RADS grading method.The differences in CEUS imaging characteristics,BI-RADS,and CEUS-BI-RADS grading between the two groups were compared,and the differential diagnostic value of conventional ultrasound combined with CEUS for IDP and breast cancer was analyzed by receiver operating characteristic(ROC)curve.Results There were statistically significant differences in BI-RADS grading and CEUS-BI-RADS grading between the two groups(P<0.05),and significant differences were found in the enhancement order,enhancement phase,posterior boundary,the proportion of enhancement range,and the proportion of crab foot between the IDP and breast cancer groups(P<0.05).The area under the curve(AUC)value of BI-RADS grading for the differential diagnosis of IDP and breast cancer was 0.783(95%CI:0.569~0.891),while the AUC value of CEUS-BI-RADS grading for the differential diagnosis of IDP and breast cancer was 0.914(95%CI:0.738~0.982).There was a statistically significant difference in the diagnostic value between the two methods(P<0.05).Conclusion Conventional ultrasound combined with CEUS can improve the accuracy of the early differential diagnosis of IDP and breast cancer,guiding clinical treatment and improving patient prognosis and quality of life.

关 键 词：乳头状瘤管内 超声造影 乳腺癌 诊断 鉴别 超声检查 乳房 

分 类 号：R737.904.5[医药卫生—肿瘤]