超声造影对乳腺BI－RADS4类结节鉴别诊断价值

摘要

目的:研究超声造影对乳腺 BI－RADS 4类结节良恶性的鉴别诊断价值.方法:回顾性分析本院60例乳腺 BI－RADS 4类结节常规超声及超声造影检查资料,观察乳腺超声造影增强模式,分析良恶性结节之间超声造影增强特征的差异,并与穿刺活检或术后病理结果对照.结果:乳腺良恶性结节超声造影增强过程中其增强强度、增强时间、增强完整性方面有显著性差异(P＜0.05),但在超声造影增强过程中增强顺序、增强均匀性方面尚未发现有显著差异(P＞0.05).常规超声BI－RADS对乳腺良恶性结节诊断效能的的灵敏度、特异度、阳性预测值、阴性预测值分别为81.8％(18/22)、73.7％(28/38)、64.3％(18/28)和87.5％(28/32),超声造影判断乳腺BI－RADS 4类结节良恶性的灵敏度、特异度、阳性预测值、阴性预测值分别为90.9％(20/22)、86.8％(33/38)、88.0％(22/25)和94.3％(33/35).超声造影对乳腺良恶性结节的诊断价值与病理结果的Kappa值为0.75,具有较好的一致性.结论:乳腺超声造影不同增强特征对乳腺 BI－RADS 4类结节良恶性判断有较高的准确性,在指导临床治疗策略方面具有明确的应用价值.%Objective:To study the diagnostic value of contrast－enhanced ultrasound in diagnosing breast nodules in BI－RADS 4.Methods:Select 60 cases of breast nodules in US BI－RADS 4 in the department of ultrasound in our hospital by routine examination and ultrasound contrast－enhanced,categorizing performance enhancement pat-tern,and comparing with pathological results.Results:There were significant differences in enhancement intensity,en-hancement phase and enhancement integrity in contrast enhanced contrast mode(P＜0.05),but there was no signifi-cant difference in enhancement order and enhancement uniformity in contrast enhanced model(P＞0.05).The sensi-tivity,specificity,positive predictive value and negative predictive value of conventional ultrasound BI－RADS in the diagnosis of benign and malignant breast nodules were 81.8％(18/22),73.7％(28/38),64.3％(18/28)and 87.5％(28/32),respectively.The sensitivity,specificity,positive predictive value and negative predictive value of the con-trast enhanced wtrasound in BI －RADS 4 benign and malignant nodules were 90.9％(20/22),86.8％(33/38),88.0％(22/25)and 94.3％(33/35).The diagnostic value of contrast－enhanced ultrasound and benign and malig-nant nodules was 0.75,with a good agreement rate.Conclusion:Different contrast patterns of ultrasound contrast have good diagnostic value for benign and malignant nodules of BI－RADS 4.