| 摘要: |
| 目的 探讨超声造影(contrast-enhancement ultrasound,CEUS)检查对提高乳腺BI-RADS 3、4类肿块良恶性诊断的价值。方法 收集2019年3月至2020年4月在辽宁省朝阳市中心医院就诊患者71例,最终经穿刺活检或手术病理证实的乳腺肿块共76个。对纳入研究的肿块行常规超声及CEUS检查,并行BI-RADS分类及CEUS评分。根据CEUS评分结果,重新调整乳腺BI-RADS 3、4类肿块分类,比较调整前、后BI-RADS分类对乳腺BI-RADS 3、4类肿块良恶性的诊断效能。结果 ①76个乳腺肿块中,良性肿块43个,恶性肿块33个；调整后BI-RADS分类2类7个、3类12个(3类保持不变4个)、4a类20个(3类上调2个)、4b类15个、4c类11个、5类11个,BI-RADS 4类肿块活检率降至69.8%,误诊率仅为1.6%。②调整前、后BI-RADS分类诊断的灵敏度、特异度、总符合率分别为75.8%、76.7%、76.3%；97.0%、88.4%、92.1%。③调整前、后BI-RADS分类的ROC曲线下面积分别为0.763、0.927,差异有统计学意义(Z=3.965,P<0.05)。结论 常规超声结合CEUS检查调整BI-RADS分类后可以提高乳腺BI-RADS 3、4类肿块良恶性的诊断,减少BI-RADS 4类肿块不必要的穿刺活检。 |
| 关键词: 乳腺肿块 超声造影 乳腺影像报告和数据系统 |
| DOI： |
| 投稿时间：2020-07-02修订日期：2020-07-27 |
| 基金项目: |
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| Diagnostic value of contrast-enhanced ultrasound in breast BI-RADS type 3 and 4 tumors |
| zhuguixin,wushuang,dongliyang,liyanhui |
| () |
| Abstract: |
| Objective To explore the value of contrast-enhancement ultrasound(CEUS) examination in improving the diagnosis of benign and malignant breast BI-RADS types 3 and 4 tumors. methods A total of 76 breast masses confirmed by biopsy or surgical pathology were collected from 71 patients who were admitted to the Chaoyang Central Hospital in Liaoning Province from March 2019 to April 2020. All the tumors included in the study were examined by conventional ultrasound and CEUS, and were paralleled with BI-RADS classification and CEUS score. According to the CEUS score results, readjust the classification of breast BI-RADS type 3 and 4 tumors, and compare the diagnostic efficacy of the BI-RADS classification before and after adjustment to the benign and malignant breast BI-RADS type 3 and 4 tumors. Results ①Of the 76 breast lumps, 43 were benign and 33 were malignant; after adjustment, the BI-RADS classification was 7 in 2 categories, 12 in 3 categories (4 in 3 categories remained unchanged), and 20 in 4a categories (up 2 in category 3 ), 15 types 4b, 11 types 4c, and 11 types 5; the biopsy rate of BI-RADS type 4 tumors decreased to 69.8%, the misdiagnosis rate is only 1.6%. ②The sensitivity, specificity, and accuracy of BI-RADS classification diagnosis before and after adjustment were 75.8%, 76.7%, 76.3%, 97.0%, 88.4%, and 92.1%, respectively. ③The areas under the ROC curve of the BI-RADS classification before and after adjustment were 0.763 and 0.927, respectively, the difference was statistically significant (Z=3.965, P<0.05). Conclusion CEUS examination combined with BI-RADS classification can improve the diagnosis of benign and malignant breast BI-RADS 3 and 4 tumors, and reduce unnecessary biopsy of BI-RADS 4 tumors. |
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