VueBox超声造影定量参数联合超声特征鉴别肉芽肿性小叶性乳腺炎与早期浸润性乳腺癌的诊断价值
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西安交通大学第二附属医院

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陕西省自然科学基础研究计划项目(S2022-JC-YB-1621)


The diagnostic value of VueBox contrast-enhanced ultrasound quantitative parameters combined with ultrasound features in differentiating granulomatous lobular mastitis and early invasive breast cancer
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    摘要:

    目的:探讨VueBox软件定量参数联合常规超声特征鉴别肉芽肿性小叶性乳腺炎(Granulomatous Lobular Mastitis,GLM)与早期浸润性乳腺癌( Invasive Breast Cancer, IBC )的诊断价值。 方法:回顾性分析我院自2021年3月至2021年12月经病理结果证实的GLM患者30例、早期IBC 患者49例(79个结节)。患者均行常规超声及超声造影检查,通过VueBox软件绘制造影时间-强度曲线并获得12个定量参数。对造影定量参数及常规超声特征进行组间比较。利用主成分分析提取鉴别诊断早期IBC及GLM重要的参数及特征,并建立联合诊断模型,通过绘制受试者工作特征曲线(receiver operating curve , ROC)及计算曲线下面积来评价此模型的诊断效能。 结果:GLM与早期IBC 组比较结果显示:结节的回声、边缘、形态(成角、毛刺)、窦帽征、是否向脂肪组织浸润、病灶周围组织水肿、增强、钙化在两组间具有显著性差异(P<0.05);GLM组患者发病年龄小,病灶直径大,距离乳头近,mTTI值低于早期IBC 组PE、WiR、WoR、WiPI、WiAUC值均高于早期IBC 组,且在两组间差异均具有统计学意义(P<0.05)。主成分联合病灶特征的模型的ROC面积为0.694, 最佳临界值为2729.9,对应的灵敏度、特异度、诊断准确率分别是83.3%,46.9%与60.7%。 结论:超声造影VueBox软件定量参数联合常规超声特征在鉴别GLM与早期IBC 中有一定的诊断价值,可以辅助医师减少GLM的误诊及IBC的漏诊。

    Abstract:

    Objective: To investigate the diagnostic value of VueBox quantitative parameters combined with conventional ultrasound features in differentiating Granulomatous Lobular Mastitis (GLM) from early invasive breast cancer (IBC). Methods: Thirty GLM patients and 49 early IBC patients (79 nodules) confirmed by pathological results in our hospital from March 2021 to December 2021 were retrospectively analyzed. All patients underwent the conventional ultrasound exam and contrast-enhanced utrasound (CEUS) exam, and VueBox software was used to draw contrast time-intensity curves and obtained 12 quantitative parameters. Inter-group comparisons were made for quantitative contrast parameters and conventional ultrasound characteristics. Principal component analysis was used to extract important parameters and characteristics for differential diagnosis of early IBC and GLM, and a joint diagnostic model was established. The diagnostic performance of the model was evaluated by drawing receiver operating curve (ROC) and calculating the area under the curve. Results: In comparison of two groups of GLM and early IBC, it showed that lesions’ echo, edge, shape (angulation, burr), sinus cap sign, infiltration into adipose tissue, tissue edema around the lesion, enhancement, calcification represented statistically significant difference (P<0.05). Compared with the early IBC patients, the GLM patients happened younger age and closer to the nipple, and lesions showed larger diameter and lower mTTI values. The differences were all statistically significant (P<0.05). The ROC area of model consisted of the principal components and lesions’ features was 0.694 , the cutoff was 2729.9, and its corresponding sensitivity, specificity and diagnostic accuracy were 83.3%, 46.9% and 60.7%, respectively. Conclusion: It is a certain value of differentiating GLMs from early IBCs using CEUS VueBox quantitative parameters combined with conventional ultrasound features, thereby reducing the misdiagnose of GLM and miss diagnosis of IBC patients.

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第一作者:王娟,梁汝娜,余珊珊,何鑫,陈阿倩,侯慧垚,井佳瑜,张瑾晖,周琦,姜珏. VueBox超声造影定量参数联合超声特征鉴别肉芽肿性小叶性乳腺炎与早期浸润性乳腺癌的诊断价值[J].临床超声医学杂志,2023,25(5):

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  • 收稿日期:2022-09-08
  • 最后修改日期:2022-10-28
  • 录用日期:2022-10-31
  • 在线发布日期: 2023-05-26
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