超声造影优化乳腺BI-RADS 4类结节诊断效能的应用研究  

Application of Contrast-Enhanced Ultrasound to Optimize the Diagnostic Efficiency of Breast BI-RADS 4 Nodules

作　　者：邓芸霞 李玲玲 陆婵 张尹俞 肖霞 胡巧[1] Deng Yunxia;Li Lingling;Lu Chan;Zhang Yinyu;Xiao Xia;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》2024年第11期1228-1232,共5页Chinese Journal of Ultrasound in Medicine

基　　金：广西重点研发计划(No.桂科AB24010145)。

摘　　要：目的分析超声造影(CEUS)定性特征及定量参数提高乳腺BI-RADS 4类结节诊断效能的应用价值。方法乳腺BI-RADS 4类结节252例,选取CEUS定量参数中评估效能较优者与定性特征联合评分再分类,比较单一诊断和联合诊断方式在BI-RADS 4类结节中诊断效能的差异。结果良性组与恶性组比较,CEUS增强强度、增强范围、结节周边有无穿支血管以及峰值强度(PE)、流入相斜率(WiR)、流出相斜率(WoR)、流入相曲线下面积(WiAUC)、流出相曲线下面积(WoAUC)、流入相灌注指数(WiPI)和达峰时间(TTP)差异均具有统计学意义(P<0.05)。CEUS定量参数及定性特征两者联合诊断乳腺恶性结节的灵敏度、特异度、阳性预测值、阴性预测值及AUC分别为79.9%、84.3%、93.9%、97.4%及0.894,诊断效能较单一诊断指标更优。结论超声造影定性与定量参数联合诊断可提高乳腺BI-RADS 4类结节的诊断效能。Objective To analyze the application value of the qualitative characteristics and quantitative parameters of contrast-enhanced ultrasound(CEUS)in the diagnostic efficacy of the breast imaging reporting and data system(BI-RADS)category 4 nodules.Methods A total of 252 BI-RADS category 4 breast nodules were included and were reclassified after contrast-enhanced ultrasound(CEUS).The superior indicators of CEUS quantitative parameters were combined with the qualitative characteristics to establish a joint scoring system.The differences of diagnostic efficiency between single and combined indicators of CEUS in BI-RADS category 4 nodules were compared.Results There were significant differences in the enhancement intensity,enhancement range,the presence of penetrating vessels and the peak enhancement(PE),wash-in rate(WiR),wash-out AUC(WoAUC),wash-in area under the curve(WiAUC),wash-out rate(WoR),wash-in perfusion index(WiPI),the time to peak(TTP)between the benign and malignant groups(P<0.05).The sensitivity,specificity,positive predictive value,negative predictive value and AUC of combined using qualitative characteristic and quantitative parameter in the diagnosis of breast malignant nodules were 79.9%,84.3%,93.9%,97.4%and 0.894,respectively,which were superior to that of single quantitative or qualitative indicator.Conclusions The combined use of qualitative characteristics and quantitative parameters of CEUS can improve the diagnostic efficiency of BI-RADS 4 nodules.

关 键 词：乳腺癌 BI-RADS分类 超声造影 VueBox^(■) 

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]