超声造影联合弹性成像在BI-RADS 4a类结节穿刺活检中的应用价值  

Application Value of Contrast-Enhanced Ultrasound Combined with Elastography in BI-RADS 4a Nodule Biopsy

作　　者：陈勇辉[1] 蔡冠晖 CHEN Yonghui;CAI Guanhui(Department of Ultrasound Medicine,Huizhou Central People's Hospital,Huizhou 516001,China;Department of Radiology,Huizhou Central People's Hospital,Huizhou 516001,China)

机构地区：[1]惠州市中心人民医院超声医学科,广东惠州516001 [2]惠州市中心人民医院放射科,广东惠州516001

出　　处：《临床医学工程》2025年第2期169-172,共4页Clinical Medicine & Engineering

摘　　要：目的分析超声造影联合弹性成像在乳腺影像报告和数据系统(BI-RADS)4a类结节穿刺活检中的应用价值。方法选取我院2022年1月至2024年12月收治的250例高度疑似BI-RADS 4a类乳腺结节患者,均实施超声造影及弹性成像检查。以病理活检穿刺作为金标准,分析超声造影及弹性成像单一及联合检查的临床诊断价值。结果病理活检穿刺结果显示,250例高度疑似BI-RADS 4a类乳腺结节患者中有120例良性(良性组)、130例恶性(恶性组)。超声造影检查结果显示148例良性、102例恶性,敏感度为59.23%,特异度为79.17%,准确性为68.80%,误诊率为20.83%,漏诊率为40.77%。弹性成像检查结果显示144例良性、106例恶性,敏感度为64.62%,特异度为81.67%,准确性为72.80%,误诊率为18.33%,漏诊率为35.38%。超声造影联合弹性成像检查结果显示124例良性、126例恶性,敏感度为93.08%,特异度为95.83%,准确性为94.40%,误诊率为4.17%,漏诊率为6.92%。超声造影联合弹性成像的敏感度、特异度、准确性均明显高于单一检查,误诊率与漏诊率均明显低于单一检查(P<0.05)。恶性组超声造影评分、肿块直径、BI-RADS评分、阻力指数、搏动指数、弹性模量值有关指标(平均值、方差值以及最大值)、乳腺肿块与同层低脂肪弹性平均值的比值明显高于良性组(P<0.05)。结论BI-RADS 4a类乳腺结节患者应用超声造影联合弹性成像的临床诊断价值高于单一超声造影检查或单一弹性成像检查。Objective To analyze the application value of contrast-enhanced ultrasound combined with elastography in breast imaging report and data system(BI-RADS)4a nodule biopsy.Methods 250 patients with highly suspected BI-RADS 4a breast nodules admitted to our hospital from January 2023 December 2024 were selected and given contrast-enhanced ultrasound and elastography.Taking pathological biopsy as the gold standard,the clinical diagnostic value of single and combined examination of contrast-enhanced ultrasound and elastography was analyzed.Results Pathological biopsy results showed that among 250 patients with highly suspected BI-RADS 4a breast nodules,120 were benign(benign group)and 130 were malignant(malignant group).Contrast-enhanced ultrasound results showed that 148 were benign and 102 were malignant,with the sensitivity of 59.23%,the specificity of 79.17%,the accuracy of 68.80%,the misdiagnosis rate of 20.83%,and the missed diagnosis rate of 40.77%.Elastography results showed that 144 were benign and 106 were malignant,with the sensitivity of 64.62%,the specificity of 81.67%,the accuracy of 72.80%,the misdiagnosis rate of 18.33%,and the missed diagnosis rate of 35.38%.Contrast-enhanced ultrasound combined with elastography results showed that 124 were benign and 126 were malignant,with the sensitivity of 93.08%,the specificity of 95.83%,the accuracy of 94.40%,the misdiagnosis rate of 4.17%,and the missed diagnosis rate of 6.92%.The sensitivity,specificity,and accuracy of contrast-enhanced ultrasound combined with elastography were significantly higher than those of single examination,and the misdiagnosis rate and missed diagnosis rate were significantly lower than those of single examination(P<0.05).The ultrasound contrast scores,tumor diameter,BI-RADS score,resistance index,pulsatility index,elastic modulus values(mean,variance,and maximum),and the ratio of breast tumors to the average low-fat elasticity of the same layer in the malignant group were significantly higher than those in the benign group(P<0.05).Con

关 键 词：乳腺影像报告和数据系统 4a类乳腺结节 超声造影 弹性成像 诊断价值 

分 类 号：R737.9[医药卫生—肿瘤]