超声造影在常规超声BI-RADS 4类病变中的应用——与DCE-MRI的对比研究

摘要

目的 探讨超声造影(CEUS)在常规超声BI-RADS 4类乳腺病变中的临床应用价值,并与动态增强磁共振(DCE-MRI)对比研究.方法 选取86个常规超声发现的BI-RADS 4类乳腺病灶,均进行超声造影及磁共振增强检查,采用BI-RADS分类法进行重新分类,以病理结果为金标准,比较两种影像学检查方法的诊断效能.结果 乳腺恶性病变65个,良性病变21个,CEUS和DCE-MRI两种诊断方法的敏感度、特异度、阳性预测值、阴性预测值分别为89.23%、80.95%、93.55%、70.83%;92.31%、85.71%、95.24%、78.26%,二者差异无统计学意义(P>0.05).常规超声BI-RADS 4类病变降至3类:CEUS 17个,DCE-MRI 18个;BI-RADS 4类升至5类病变:CEUS 11个,DCE-MRI 13个.结论 在常规超声的基础上,超声造影对于常规超声BI-RADS 4类乳腺病变,能够进一步提供更多的诊断信息,与增强磁共振具有较好的一致性,具有较好的临床应用价值.%Objective To compare contrast-enhanced ultrasound (CEUS) and dynamic contrast-enhanced magnetic reso-nance imaging (DCE-MRI) in the diagnosis of BI-RADS 4 breast lesions. Methods 86 lesions were underwent by ultrasonic CEUS and DCE-MRI. Using the pathologic findings as the gold standard, the diagnostic sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 86 lesions on CEUS and DCE-MRI were calculated. Results In 65 malignant and 21 benign lesions, the 89.23% sensitivity, 80.95% specificity, 93.55% PPV and 70.83% NPV of CEUS were not significantly different from that of DCE-MRI (92.31%, 85.71%, 95.24%, 78.26%). Conclusion CEUS is valuable in the differential diagnosis of BI-RADS 4 breast lesions and has a good agreement with DCE-MRI.