多模态超声对70例BI-RADS 4类乳腺病变的诊断价值

doi:10.6040/j.issn.1671-7554.0.2022.1214

摘要/Abstract

摘要： 目的探究多模态超声对乳腺影像报告与数据系统( BI-RADS)4类乳腺病变的诊断价值。方法选取行乳腺病变穿刺活检或切除术患者63例共70个BI-RADS 4类病灶,包括良性病变40个(良性组)与恶性病变30个(恶性组),对其一般临床特征、术前超声诊断信息、术后病理资料进行回顾性分析。结果 BI-RADS 4类乳腺良恶性病变在结节形状、生长方向、内部回声、边缘、边界、后方回声衰减、钙化等方面均差异无统计学意义(P>0.05),而在高回声晕、Adler血流分级方面差异有统计学意义(P<0.05)。恶性组的剪切波传播速度最大值(SWVmax)、弹性成像/B模式比(EI/B)、应变比(SR)均高于良性组,差异有统计学意义(P<0.05)。SWVmax的受试者工作特征曲线下的面积(AUC)为0.94,最佳截断值为2.85 m/s,诊断的灵敏度和特异度分别为86.7%和95.0%。EI/B的AUC为0.92,最佳截断值为1.01,诊断的灵敏度和特异度分别为96.7%和82.5%。SR的AUC为0.78,最佳截断值为7.86,诊断的灵敏度和特异度分别为76.7%和72.5%。多因素二分类Logistic分析结果显示,与良性组比较,BI-RADS 4类乳腺恶性结节的SWVmax和EI/B的OR值分别为12.97(P<0.05)和1.51(P<0.05)。结论合理应用多模态超声检查可有效鉴别BI-RADS 4类乳腺良恶性病变,减少不必要的穿刺活检。

关键词: 乳腺, 超声, 剪切波弹性成像, 应变弹性成像

Abstract: Objective To explore the diagnostic value of multi-modal ultrasound in Breast Imaging Reporting and Data System(BI-RADS)category 4 breast lesions. Methods A total of 70 BI-RADS category 4 lesions in 63 patients who underwent needle biopsy or resection of breast lesions were selected, including 40 benign lesions(benign group)and 30 malignant lesions(malignant group). The general clinical features, preoperative ultrasound diagnosis, and postoperative pathologic results were reviewed. Results There were no significant differences in nodule shape, orientation, internal echogenicity, margin, boundary, posterior echo attenuation and calcification between benign and malignant breast lesions(P>0.05). However, significant differences were observed in hyperechoic halos and Adler flow grades(P<0.05). The maximum value of shear wave velocity(SWVmax), elasticity imaging/B-mode ratio(EI/B), and strain ratio(SR)were higher in the malignant group than in the benign group, with significant differences(P<0.05). The area under the receiver operating characteristic curve(AUC)for SWVmax was 0.94, and the optimal cutoff value, diagnostic sensitivity and specificity were 2.85 m/s, 86.7% and 95.0%, respectively. The AUC for EI/B was 0.92, and the optimal cutoff value, and diagnostic sensitivity and specificity were 1.01, 96.7% and 82.5%, respectively. The AUC for SR was 0.78, and the optimal cutoff value, diagnostic sensitivity and specificity were 7.86, 76.7% and 72.5%, respectively. Multivariate binary Logistic analysis showed that the OR of SWVmax and EI/B of the malignant group were 12.97(P<0.05)and 1.51(P<0.05), respectively. Conclusion Reasonable application of multi-modal ultrasound is able to effectively identify benign and malignant BI-RADS category 4 breast lesions and reduce unnecessary needle biopsies.

Key words: Breast, Ultrasound, Shear wave elastography, Strain elastography

中图分类号:

R445.1

徐帅娅,罗芳琼,巴晨曦,张鑫茹,马喆. 多模态超声对70例BI-RADS 4类乳腺病变的诊断价值[J]. 山东大学学报 (医学版), 2023, 61(2): 95-101.

XU Shuaiya, LUO Fangqiong, BA Chenxi, ZHANG Xinru, MA Zhe. Diagnostic value of multi-modal ultrasound in 70 cases of BI-RADS category 4 breast lesions[J]. Journal of Shandong University (Health Sciences), 2023, 61(2): 95-101.

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