乳腺常规超声与超声造影对早期乳腺癌的诊断价值

Diagnostic value of conventional ultrasound and contrast-enhanced ultrasound in the diagnosis of early-stage breast cancer

目的探讨乳腺常规超声与超声造影对早期乳腺癌的诊断价值。方法选取2016年5月至2019年5月间西安交通大学第二附属医院收治的80例早期乳腺癌患者进行回顾性研究,所有患者分别进行常规超声检查和超声造影检查。分析良恶性乳腺肿瘤的特征,并与穿刺或术后病理结果进行比较,分析两种检测方法的诊断价值。结果超声造影结果提示,乳腺恶性肿瘤主要为不均匀增强及周边增强,乳腺良性肿瘤主要为无增强和均匀增强为主。33例患者经常规超声诊断,良性16例,恶性17例,其中误诊10例(4例误诊为良性,6例误诊为恶性);47例患者经超声造影诊断,良性12例,恶性35例,其中误诊5例(良性误诊2例、恶性误诊3例)。常规超声诊断良恶性乳腺疾病的敏感性、特异性、阳性预测值和阴性预测值分别为64.7%、75.0%、73.3%和66.7%。超声造影诊断良恶性乳腺疾病的敏感性、特异性、阳性预测值和阴性预测值分别为94.1%、76.9%、91.4%和83.3%。超声造影的敏感度明显高于常规造影,差异有统计学意义(P<0.05)。结论常规超声联合超声造影可提高早期乳腺癌的诊断敏感度,在早期乳腺癌的诊断以及良恶性肿瘤的鉴别诊断中有重要的临床应用价值。

Objective To investigate the diagnostic value of conventional ultrasound and contrastenhanced ultrasound in the diagnosis of early-stage breast cancer.Methods Eighty patients with earlystage breast cancer who admitted to the Second Affiliated Hospital of Xi’an Jiaotong University were selected for a retrospective study between May 2016 and May 2019.The patients were examined using conventional ultrasound or contrast-enhanced ultrasound,respectively.The features of benign and malignant tumors were analyzed and were compared with puncture or post-operative pathology results.The diagnostic value of the two methods was analyzed.Results Contrast-enhanced ultrasound showed that the enhancement of malignant breast tumors was mainly inhomogeneous enhancement and peripheral enhancement,while the enhancement of benign breast tumors was mainly non-enhancement and uniform enhancement.Benign tumors were found in 16 patients and malignant tumors were found in 17 patients among the 33 patients diagnosed using conventional ultrasound with 10 cases of misdiagnosis(4 patients with benign tumors and 6 patients with malignant tumors).Benign tumors were found in 12 patients and malignant tumors were found in 35 patients among 47 patients diagnosed using contrast-enhanced ultrasound with 5 cases of misdiagnosis(2 patients with benign tumors and 3 patients with malignant tumors).The sensitivity,specificity,and positive and negative predictive value was 64.7%,75.0%,73.3%and 66.7%,respective for conventional ultrasound and94.1%,76.9%,91.4%and 83.3%,respectively for contrast-enhanced ultrasound.The sensitivity was significantly higher for the contrast-enhanced ultrasound than for the conventional ultrasound(P<0.05).Conclusion Contrast-enhanced ultrasound could improve the diagnostic sensitivity for the diagnosis of early breast cancer.It has important clinical value in the diagnosis of early breast cancer and the differential diagnosis of benign and malignant tumors.