超声弹性成像联合超声造影在乳腺 BI-RADS 4级肿块良恶性鉴别诊断中的价值

摘要

目的：探讨超声弹性成像（UE）联合超声造影（CEUS）在乳腺 BI-RADS 4级肿块良恶性鉴别诊断中的应用价值。方法对112例乳腺 BI-RADS 4级肿块患者行超声弹性成像和超声造影检测，并对术后病理结果进行对比。结果112例患者共125个乳腺肿块，病理学诊断良性85例，恶性40例。85个良性乳腺肿块超声弹性成像评分（2．56±0．48）分，40个恶性乳腺肿块评分（3．85±0．67）分，恶性乳腺肿块超声弹性成像评分较良性乳腺肿块显著升高（P ＜0．05）；良、恶性乳腺肿块超声造影形态特征在增强水平、对比剂分布、增强方式、肿块内血管形态、增强后边界、肿块周边放射状增强、造影后肿块大小等方面比较差异均有统计学意义（P ＜0．05）。超声弹性成像、超声造影及二者联合诊断的敏感性分别为75．0％、82．5％、92．5％，特异性分别为89．4％、85．9％、94．1％，准确性分别为84．8％、84．8％、93．6％。二者联合诊断的的敏感性、特异性及准确性均显著高于二者单独应用，差异具有统计学意义（P ＜0．05）。结论超声弹性成像联合超声造影技术更有助于乳腺 BI-RADS 4级肿块良恶性的鉴别。%Objective TO investigate the value of ultrasonic elastography(UE)combined with contrast-enhanced ultrasonography(CEUS)in the differential diagnosis of Breast Imaging Repor-ting and Data System(BI-RADS)4 lesions.Methods A total of 112 patients with BI-RADS 4 le-sions underwent UE and CEUS.The diagnostic results were compared with postoperative pathol-ogy.Results Among the 125 breast masses,pathological diagnosis showed benign lesions in 85, and malignant lesions in 40.The UE score of malignant lesions(3.85 ± 0.67)was significantly higher than that of benign lesions(2.56±0.48)(P <0.05).Furthermore,there were significant differences between benign and malignant lesions in the morphological characteristics of CEUS, including enhancement level,contrast medium distribution,enhancement pattern,vascular mor-phology,enhanced border,peripheral radial enhancement and lesion size(P <0.05).The sensitivi-ties of UE,CEUS and their combination for identifying BI-RADS 4 lesions were respectively 75. 0%,82.5% and 92.5%,the specificities were respectively 89.4%,85.9% and 94.1%,and the ac-curacies were respectively 84.8%,84.8% and 93.6%.Compared with UE or CEUS alone,their combination significantly increased the sensibility,specialty and accuracy for identifying BI-RADS 4 lesions(P <0.05).Conclusion The combination of UE and CEUS is helpful for identifying be-nign and malignant BI-RADS 4 lesions.