超声造影在乳腺BI-RADS评分4类病变穿刺活检中的应用价值

The value of contrast-enhanced ultrasound in the biopsy of breast cancer with BI-RADS score of 4 lesions

目的探讨超声造影在乳腺影像报告和数据系统(BI-RADS)评分4类病变患者穿刺活检中的应用价值。方法选取本院2017年6月至2018年5月收治的136例乳腺BI-RADS评分4类的患者,采用随机数字表法分为超声造影组与普通超声组,各68例。超声造影组行超声造影引导下乳腺结节穿刺活检术,普通超声组行普通超声引导下乳腺结节穿刺活检术。比较两组穿刺成功率、穿刺进针次数、取材满意率、诊断灵敏度、诊断特异度、诊断符合率、穿刺不良反应发生率。结果两组的穿刺成功率均为100%。超声造影组进针(2.89±0.56)次,普通超声组进针(2.93±0.62)次,差异无统计学意义(P>0.05)。超声造影组取材满意率100%(68/68),普通超声组94.12%(64/68),差异无统计学意义(P>0.05)。超声造影组与普通超声组灵敏度分别为88.89%(32/36)与81.82%(27/33),差异无统计学意义(P>0.05)。超声造影组特异度与符合率为100%(32/32)与94.12%(64/68),高于普通超声组80.65%(25/31)与81.25%(52/64),差异有统计学意义(P<0.05)。普通超声组与超声造影组穿刺不良反应发生率分别为10.94%(7/64)与2.94%(2/68),差异无统计学意义(P>0.05)。结论超声造影引导下穿刺活检对乳腺BI-RADS评分4类病变患者可获得较高穿刺成功率,并有助于确认病变活性、坏死液化区域,更准确的定位取材,提高取材满意率及穿刺活检的诊断效能,临床价值显著。

Objective To explore the value of contrast-enhanced ultrasound in the biopsy of patients with breast imaging reporting and data system( BI-RADS) score of 4 lesions. Methods Total of 136 cases of breast BI-RADS scores of 4 lesions admitted to Dongguan People’s Hospital from June 2017 to May2018 were enrolled and randomly divided into contrast-enhanced ultrasound group and general ultrasound group,68 cases in both group. The contrast-enhanced ultrasound group received contrast-enhanced ultrasound-guided breast nodule biopsy,and the general ultrasound group received general ultrasound-guided breast nodule biopsy. The success rate of puncture,the number of puncture needles,the satisfaction rate of the materials,the diagnostic sensitivity,the diagnostic specificity,the diagnostic coincidence rate,and the incidence of adverse puncture reactions were compared between two groups. Results The puncture success rate of both groups were 100%. The number of puncture needles in contrast-enhanced ultrasound group was( 2. 89 ± 0. 56) times,and the general ultrasound group was( 2. 93 ± 0. 62) times,with no statistically significant difference( P > 0. 05). The satisfaction rate of materials in the contrast-enhanced ultrasound group was 100%( 68/68),and the general ultrasound group was 94. 12%( 64/68),with no statistically significant difference( P > 0. 05). The sensitivity in the contrast-enhanced ultrasound group and the general ultrasound group were 88. 89%( 32/36) and 81. 82%( 27/33),respectively,with no statistically significant difference( P > 0. 05). The specificity and coincidence rate in contrast-enhanced ultrasound group were 100%( 32/32) and 94. 12%( 64/68),which were higher than 80. 65%( 25/31) and 81. 25%( 52/64) of the general ultrasound group,with statistically significant difference( P < 0. 05). The incidence of adverse reactions in the general ultrasound group and the contrast-enhanced ultrasound group were 10. 94%( 7/64)and 2. 94%( 2/68),respectively,with no statistically significant difference( P > 0. 05). Conclusions The contrast-enhanced ultrasound-guided breast nodule biopsy can achieve high puncture success rate in patients with breast cancer with BI-RADS scores 4 lesions,and help to confirm lesion activity,necrotic liquefaction area,more accurate localization,improved material satisfaction rate and biopsy,diagnostic efficacy,with significant clinical value.