摘要
目的 分析良、恶性非肿块乳腺病变(NML)的灰阶超声(US)、超声造影(CEUS)及剪切波弹性成像(SWE)特征,探讨US、CEUS联合SWE诊断非肿块乳腺病变的价值。资料与方法 前瞻性分析2021年1—8月于解放军总医院行US、CEUS及SWE检查,随后均行穿刺活检、旋切活检或手术的44例女性患者,共47个乳腺病灶,对NML的US、CEUS及SWE特征进行定性及定量研究。分析多模态超声的诊断敏感度、特异度、阳性预测值、阴性预测值和受试者工作特征曲线,评价其诊断效能。结果 病理结果显示26个良性病灶,21个恶性病灶。与良性NML比较,非肿块型乳腺癌在内部血流,有无钙化(χ^(2)=5.70),增强范围(χ^(2)=22.90),有无滋养血管(χ^(2)=10.77),最大、平均、最小弹性模量(U=103.00、96.50、102.00),与周围组织弹性比(U=93.50)及“硬环征”检出率(χ^(2)=13.58)等差异均有统计学意义(P均<0.05)。联合US、CEUS及SWE的多模态超声对NML的诊断敏感度、特异度、阳性预测值、阴性预测值分别为95.2%、96.2%、95.3%、96.1%,其曲线下面积大于US(0.976比0.841;Z=3.432,P=0.027)。结论 联合US、CEUS及SWE多模态超声有助于区分良、恶性NML,其诊断效能高于常规超声。
Purpose To investigate the features of B-mode ultrasound(US), contrast-enhanced ultrasound(CEUS) and shear wave elastography(SWE) in benign and malignant non-mass breast lesions(NML), and to explore the application value of US, CEUS and SWE in NML. Materials and Methods This prospective analysis was conducted in the PLA General Hospital. From January 2021 to August 2021,44 female patients(47 breast lesions) underwent US, CEUS and SWE examinations. The US, CEUS and SWE characteristics of NML were qualitatively and quantitatively studied with the puncture biopsy, rotary biopsy and pathological results as the gold standard. The sensitivity,specificity, positive predictive value, negative predictive value and receiver operating characteristic curve of multimodal ultrasound were analyzed to evaluate its diagnostic performance. Results Clinicopathologically, 21 lesions were malignant and 26 lesions were benign. There were significant differences between non-mass breast cancer and benign NML in internal blood flow, calcification(χ^(2)=5.70), enhanced range(χ^(2)=22.90), nutrient vessels(χ^(2)=10.77), maximum, average and minimum elastic modulus(U=103.00, 96.50, 102.00), elastic ratio to surrounding tissue(U=93.50) and detection rate of “stiff rim sign”(χ^(2)=13.58)(all P<0.05). The sensitivity, specificity, positive predictive value and negative predictive value of US, CEUS and SWE in the diagnosis of NMLs were 95.2%, 96.2%, 95.3% and 96.1%, respectively. The diagnostic efficiency of US+CEUS+SWE was significantly higher than that of conventional US, which of AUC was significantly higher than that of US(0.976 vs.0.841;Z=3.432, P=0.027). Conclusion Multimodal ultrasound helps to distinguish benign and malignant NML and its diagnostic efficiency is higher than conventional ultrasound.
作者
李诗雨
牛瑞兰
王博
姜莹
王知力
LI Shiyu;NIU Ruilan;WANG Bo;JIANG Ying;WANG Zhili(Department of Ultrasound,Chinese PLA General Hospital,Beijing 100853,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2022年第3期230-234,共5页
Chinese Journal of Medical Imaging
基金
国家自然科学基金(82071925)
北京市自然科学基金-海淀原始创新联合基金(L192026)。
关键词
非肿块乳腺病变
超声检查
造影剂
弹性成像技术
病理学
外科
诊断
鉴别
Breast non-mass-like lesions
Ultrasonography
Contrast media
Elasticity imaging techniques
Pathology,surgical
Diagnosis,differential
