超声造影参数成像技术诊断乳腺良恶性结节的价值

Value of contrast-enhanced ultrasonographic parametric imaging in diagnosing benign and malignant breast nodules

目的:探索超声造影参数成像技术诊断乳腺良恶性结节的价值。方法:回顾性分析67例经病理证实的女性乳腺结节的超声造影图像。与病理结果对比,评价参数成像技术诊断乳腺良恶性结节的准确性。比较超声造影参数成像诸参数在乳腺良恶性结节的组间差异,参数包括:定量参数Area、Intensity、AT(arrival time)、AT-SD(arrival time-standard deviation)及定性参数灌注方式、灌注均匀性。并对组间差异有统计学意义的参数进一步利用ROC曲线评估其诊断价值。结果:超声造影参数成像技术诊断乳腺良恶性结节的敏感度、特异度、准确度分别为84.6%、63.4%、71.6%。年龄、定量参数Area及AT在乳腺结节良恶性组间差异有统计学意义(P<0.05),且对诊断乳腺良恶性结节有一定价值,ROC曲线下面积分别为0.77、0.80、0.82。联合年龄、Area及AT诊断乳腺结节良恶性的价值更高,ROC曲线下面积高达0.92。定量参数Intensity、ATSD和定性参数灌注方式及灌注均匀性在乳腺结节良恶性组间差异无统计学意义(P>0.05)。结论:超声造影参数成像技术是一种可用于观察乳腺病变血流动力学特点的成像工具,在诊断乳腺良恶性结节方面具有一定价值。

Objective：To explore the value of contrast -enhanced ultrasonographic parametric imaging （PI） in diagnosing benign and malignant breast nodules. Methods：Sixty - seven female breast nodules confirmed by pathology were enrolled and of which contrast - enhanced ultrasonographic images were retrospectively analyzed by PI. Diagnostic accuracy of PI was evaluated by comparing with pathological results. Quantitative parameters Area, Intensity, AT （arrival time）, AT -SD（ arrival time - standard deviation） and qualitative parameters perfusion mode, perfusion homogeneity were compared between benign and malignant groups. Receiver operating characteristic curves （ ROC curve） were used to assess the diagnostic value of statistically significant parameters furtherly. Results ： The sensitivity, specificity and accuracy of PI in diagnosing benign and malignant breast nodules were 84.6% ,63.4% and 71.6% respectively. Parameters age, AT and Area displayed statistically significant differences （ P 〈 0.05 ） between benign and malignant groups and showed a certain value in diagnosing benign and malignant breast nodules, whose areas under the ROC curves （AUC） were 0.77,0.80 and 0.82 respectively. A higher diagnostic value was obtained by combining three parameters together,which AUC was up to 0.92. However, quantitative parameters Intensity , AT -SD and qualitative parameters perfusion mode, perfusion homogeneity had no statistically significant difference between benign and malignant groups （ P 〉 0.05 ）. Conclusion ： Contrast - enhanced ultrasonographic parametric imaging is an imaging tool that can be used to observe the hemodynamic characteristics of breast lesions. It is of a certain value in the diagnosis of benign and malignant breast nodules.