超声造影到达时间参数成像在乳腺病灶血流灌注的应用研究  

Application of contrast-enhanced ultrasound arrival-time parametric imaging in blood perfusion of breast lesions

作　　者：蒋南 张筠 金壮 于馨 李玥 于天琦 曹军英 JIANG Nan;ZHANG Yun;JIN Zhuang;YU Xin;LI Yue;YU Tianqi;CAO Junying(Department of Ultrasound Diagnosis,General Hospital of Northern Theater Command,PLA,Shenyang 110016,Liaoning,China;Department of Ultrasonography,Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University/General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]北部战区总医院超声诊断科,沈阳110016 [2]南京大学医学院附属金陵医院(东部战区总医院)超声科,南京210002

出　　处：《医学研究与战创伤救治》2024年第10期1060-1064,共5页Journal of Medical Research & Combat Trauma Care

基　　金：辽宁省重点研发项目(2020JH2/10300122)。

摘　　要：目的评价到达时间参数成像(At-PI)定量参数颜色占比在乳腺良恶性结节早期血流灌注程度中的研究价值。方法回顾性分析自2021年1月至2024年3月在北部战区总医院行超声造影(CEUS)检查且有明确病理结果的66个乳腺结节,在超声诊断仪内置软件上将造影剂进入病灶的前6 s设为红色,7~12 s设为黄色,计算结节红色部分面积与黄色部分面积的比值(R/Y)、结节红色部分面积与结节总面积的比值(R/T)、结节内灌注缺损部分面积与结节总面积的比值(N/T)。用组内相关系数(ICC)评价参数观察者间一致性,分析各颜色比评估乳腺良恶性结节的受试者工作特征曲线下面积(AUC)与截断值,并计算其敏感性、特异性、准确性、阳性预测值与阴性预测值。结果各参数观察者间一致性极佳,R/Y、R/T、N/T相对应的ICC值分别为0.955、0.928、0.925,乳腺良恶性结节间R/T、R/Y差异有统计学意义(P<0.05),N/T差异无统计学意义(P=0.416)。R/Y的截断值、AUC、敏感性、特异性、准确性、阳性预测值、阴性预测值分别为0.593、0.800、0.851、0.789、0.833、0.909、0.682。R/T的截断值、AUC、敏感性、特异性、准确性、阳性预测值、阴性预测值分别为0.366、0.673、0.766、0.600、0.716、0.818、0.522。结论At-PI定量参数颜色占比能反应乳腺结节的早期血流灌注程度,可以有效提高At-PI对乳腺良恶性结节的诊断价值。Objective To evaluate the value of quantitative color proportion parameters of arrival-time parametric imaging(At-PI)in early blood perfusion of benign and malignant breast nodules.Methods A retrospective analysis was conducted on 66 breast nodules that undervent contrast-enhanced ultrasound(CEUS)examination with definitive pathological results from January 2021 to March 2024 at the General Hospital of Northern Theater Command.The built-in software of the ultrasound diagnostic apparatus set the first 6 seconds of contrast agent entering the lesion as red and the subsequent 7-12 seconds as yellow.The ratios of the red area to the yellow area(R/Y),the red area to the total area of the nodule(R/T),and the area of the perfusion defects within the nodule to the total area of the nodule(N/T)were calculated.Intraclass correlation coefficients(ICC)were used to assess inter-observer consistency for these parameters.The areas under the receiver operating characteristic curves(AUC),cutoff values,sensitivity,specificity,accuracy,positive predictive value and negative predictive value were analyzed for each color ratio in distinguishing between benign and malignant breast nodules.Results The inter-observer consistency for each parameter was excellent,with ICC values of R/Y,R/T and N/T were 0.955,0.928 and 0.925,respectively.There are statistically significantly differences in R/T and R/Y between benign and malignant breast nodules(P<0.05),while N/T showed no significant difference(P=0.416).The cut off value,AUC,sensitivity,specificity,accuracy,positive predictive value,and negative predictive value for R/Y were 0.593,0.800,0.851,0.789,0.833,0.909 and 0.682,respectively.For R/T,these values were 0.366,0.673,0.766,0.600,0.716,0.818 and 0.522 respectively.Conclusion The quantitative color ratio proportion parameters of At-PI can reflect the early blood perfusion of breast nodules and effectively enhance the diagnostic value of At-PI in benign and malignant breast nodules.

关 键 词：超声造影 到达时间参数成像 乳腺良恶性结节 

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]