摘要
目的探讨超声造影(CEUS)时间-强度曲线(TIC)及应变式弹性成像(RTE)在乳腺影像报告和数据系统(BI-RADS)4类乳腺病变鉴别诊断中的应用价值。方法选取该院2019年6月至2021年2月收治的118例BI-RADS 4类病变患者进行回顾性研究,以病理诊断为金标准,恶性病变组46例,良性病变组72例,比较两组CEUS图像特征、TIC形态及其定量参数[良恶性病变部位的CEUS达峰时间(TTP)、峰值强度(PI)],以及弹性成像应变率比值(B/A);评估两种超声诊断技术单独应用和联合应用对BI-RADS 4类病变诊断的灵敏度、特异度、准确率,绘制受试者工作特征(ROC)曲线,获得曲线下面积(AUC)。结果乳腺恶性病变组CEUS的TIC形态较陡直,TTP短于良性病变组[(13.87±3.89)s vs.(22.70±9.10)s],PI大于良性病变组[(21.25±7.32)dB vs.(11.77±4.10)dB],差异均有统计学意义(P<0.05);乳腺恶性病变组B/A大于良性病变组,差异有统计学意义(4.47±1.63 vs.2.81±1.04,P<0.05)。CEUS的TIC与RTE单独应用的诊断灵敏度、准确率有明显差异(P<0.05),RTE与CEUS+RTE的灵敏度、准确率亦有明显差异(P<0.05);ROC曲线提示CEUS+RTE诊断的AUC为0.967,CEUS诊断的AUC为0.955,RTE诊断的AUC为0.826,差异有统计学意义(P<0.05)。结论CEUS的TIC联合RTE及单独应用CEUS对BI-RADS 4类乳腺病变的鉴别诊断均有重要的临床意义,两种技术的联合应用更具参考价值。
Objective To investigate the application value of time-intensity curve(TIC)of contrast-enhanced ultrasound(CEUS)and real-time tissue elastography(RTE)for differential diagnosis of breast imaging reporting and data system(BI-RADS)category 4 breast lesions.Methods A retrospective study was conducted on 118 patients with BI-RADS category 4 lesions admitted to this hospital from June 2019 to February 2021.Taking pathological diagnosis as the gold standard,46 patients were included in the malignant lesion group,and 72 patients were included in the benign lesion group.The CEUS image features,TIC morphology and its quantitative parameters[time to peak perfusion(TTP),peak intensity(PI)in benign and malignant lesions]and elastography strain rate ratio(B/A)were compared between the two groups.The sensitivity,specificity,and accuracy of the two ultrasound diagnostic techniques alone and in combination for the diagnosis of BI-RADS category 4 lesions were evaluated,and the receiver operating characteristic(ROC)curve was drawn to obtain the area under the curve(AUC).Results The TIC morphology of CEUS in the malignant breast lesion group was steeper.The TTP in the malignant breast lesion group was shorter than that in the benign lesion group[(13.87±3.89)s vs.(22.70±9.10)s],the PI was greater than that in the benign lesion group[(21.25±7.32)dB vs.(11.77±4.10)dB],and there were statistically significant differences(P<0.05).The B/A value in the malignant breast lesion group was greater than that in the benign lesion group,and the difference was statistically significant[(4.47±1.63)vs.(2.81±1.04),P<0.05].The diagnostic sensitivity and accuracy of TIC of CEUS and RTE alone were significantly different(P<0.05),and the sensitivity and accuracy of RTE and CEUS+RTE were significantly different,as well(P<0.05).The ROC curve analysis showed that the values of AUCs of CEUS+RTE,CEUS and RTE for the diagnosis of BI-RADS category 4 lesions were 0.967,0.955,and 0.826,respectively,and the difference was statistically significant(P<0.05).Conclusion CEUS TIC combined with RTE and CEUS alone have important clinical significance in the differential diagnosis of BI-RADS category 4 breast lesions,and the combined application of the two techniques has more reference value.
作者
李晓瑜
欧阳娜
王晓燕
刘政
高云华
吴强
陈晓琴
李佩倞
LI Xiaoyu;OU Yangna;WANG Xiaoyan;LIU Zheng;GAO Yunhua;WU Qiang;CHEN Xiaoqin;LI Peijing(Department of Ultrasound,Second Affiliated Hospital of Army Medical University,Chongqing 400037,China)
出处
《重庆医学》
CAS
2022年第4期596-600,共5页
Chongqing medicine
基金
重庆市科卫联合医学科研项目(2020FYX036)。
关键词
超声造影
时间-强度曲线
应变式弹性成像
乳腺
良恶性病变
BI-RADS
4类病变
contrast-enhanced ultrasound
time-intensity curve
real-time tissue elastography
breast
benign and malignant lesions
BI-RADS category 4 lesions
