超声弹性成像联合增强CT及MRI在鉴别BI-RADS 4b类乳腺小结节(直径≤2cm)性质中的应用  

Application of Ultrasound Elastography Combined with Enhanced CT and MRI in Distinguishing the Nature of BI-RADS 4b Breast Nodules(Diameter≤2 cm)

作　　者：杨胜娇 邹雅琪 肖静[2] 伯广庆 陈超凡 YANG Shengjiao;ZOU Yaqi;XIAO Jing;BO Guangqing;CHEN Chaofan(Department of Health Management,the Seventh Affiliated Hospital of Southern Medical University,Foshan 528244,China;Department of Medical Imaging,the Seventh Affiliated Hospital of Southern Medical University,Foshan 528244,China;Department of Ultrasound,the Seventh Affiliated Hospital of Southern Medical University,Foshan 528244,China)

机构地区：[1]南方医科大学第七附属医院健康管理科,广东佛山528244 [2]南方医科大学第七附属医院医学影像科,广东佛山528244 [3]南方医科大学第七附属医院超声科,广东佛山528244

出　　处：《临床医学工程》2025年第3期274-278,共5页Clinical Medicine & Engineering

基　　金：佛山市卫生健康局医学科研课题(20240058)。

摘　　要：目的 探讨超声弹性成像联合增强CT及磁共振成像(MRI)在鉴别BI-RADS 4b类乳腺小结节(直径≤2 cm)性质中的应用价值。方法 选取南方医科大学第七附属医院2021年5月至2023年6月收治的175例BI-RADS 4b类乳腺小结节(直径≤2 cm)患者作为研究对象。患者入院后均接受超声弹性成像、增强CT及MRI检查,统计超声弹性成像、增强CT、 MRI以及三者联合对结节性质的判定结果。以病理检查结果作为金标准,比较超声弹性成像、增强CT、 MRI以及三者联合鉴别BI-RADS 4b类乳腺小结节良恶性的效能。结果 病理检查结果显示,175例BI-RADS 4b类乳腺小结节(直径≤2 cm)患者中良性109例(62.29%),恶性66例(37.71%)。恶性小结节患者的超声弹性评分显著高于良性小结节患者(P <0.05)。超声弹性成像检出良性结节90例,恶性结节85例;增强CT检出良性结节100例,恶性结节75例;MRI检出良性结节98例,恶性结节77例;超声弹性成像联合增强CT及MRI检出良性结节115例,恶性结节60例。以病理检查结果为金标准,超声弹性成像联合增强CT及MRI鉴别诊断乳腺良、恶性小结节的敏感性为77.27%、特异性为91.74%、准确性为86.29%;超声弹性成像联合增强CT及MRI的特异性显著高于超声弹性成像、增强CT、 MRI检查,准确性显著高于超声弹性成像、增强CT检查(P <0.05);各种检查方式的敏感性比较,差异无统计学意义(P>0.05)。结论 超声弹性成像、增强CT、 MRI检查均可有效评估BI-RADS 4b类乳腺小结节(直径≤2 cm)的性质,但三者联合优势更为显著,诊断特异性和准确性更高,可有效降低误诊率。Objective To explore the application value of ultrasound elastography combined with enhanced CT and magnetic resonance imaging(MRI)in distinguishing the nature of BI-RADS 4b breast nodules(diameter≤2 cm).Methods 175 patients with BI-RADS 4b breast nodules(diameter≤2 cm)admitted to the Seventh Affiliated Hospital of Southern Medical University from May 2021 to June 2023 were selected as the study subjects.After admission,all patients underwent ultrasound elastography,enhanced CT,and MRI examinations.The results of ultrasound elastography,enhanced CT,MRI,and their combination for distinguishing the nature of nodules were counted.With the pathological examination results as the gold standard,the efficacy of ultrasound elastography,enhanced CT,MRI,and their combination in distinguishing benign and malignant BI-RADS 4b breast nodules was compared.Results Pathological examination results showed that among 175 patients with BI-RADS 4b breast nodules(diameter≤2 cm),109 cases(62.29%)were benign and 66 cases (37.71%) were malignant. The ultrasound elasticity score of patients with small malignant nodules was significantlyhigher than that of patients with small benign nodules (P <0.05). Ultrasound elastography detected 90 cases of benign nodules and 85 casesof malignant nodules;Enhanced CT detected 100 cases of benign nodules and 75 cases of malignant nodules;MRI detected 98 cases ofbenign nodules and 77 cases of malignant nodules;Ultrasound elastography combined with enhanced CT and MRI detected 115 cases ofbenign nodules and 60 cases of malignant nodules. With the pathological examination results as the gold standard, the sensitivity, specificity,and accuracy of ultrasound elastography combined with enhanced CT and MRI in differentiating benign and malignant small breast noduleswere 77.27%, 91.74%, and 86.29%, respectively;The specificity of ultrasound elastography combined with enhanced CT and MRI wassignificantly higher than that of ultrasound elastography examination, enhanced CT examination andMRI examination, a

关 键 词：乳腺小结节 增强CT 超声弹性成像 磁共振成像 

分 类 号：R445[医药卫生—影像医学与核医学]