Sonazoid超声造影定量分析在乳腺肿瘤鉴别诊断中的应用

Quantitative Analysis of Sonazoid Ultrasonography in the Differential Diagnosis of Breast Tumors

目的探究Sonazoid超声造影定量分析对乳腺良、恶性肿瘤的鉴别诊断价值。资料与方法回顾性纳入2021年10月—2022年7月于北京医院超声科行乳腺结节超声造影的92例患者,共92个病灶,以穿刺或手术病理结果为“金标准”,分为良性组32例与恶性组60例,运用SonoLiver软件对造影图像进行定量分析,获得最大回声强度(IMAX)、上升时间(RT)、达峰时间(TTP)、平均渡越时间(m TT)、整体曲线的曲线下面积(AUC)5个定量分析参数及病灶的动态血管模型(DVP)参数图像及DVP曲线,分析其在乳腺良、恶性肿瘤中的差异。对5个定量参数绘制受试者工作特征曲线,获得乳腺肿瘤良恶性鉴别诊断的截断值。结果与良性组比较,恶性组的IMAX和AUC较高,而m TT较低(Z=-4.443、-3.500、-2.226,P均<0.05),两组RT、TTP差异无统计学意义(P>0.05)。当IMAX>119.38%、AUC>54854%/s、mTT<70.59 s为截断值时,IMAX、AUC、MTT鉴别诊断乳腺良、恶性肿瘤的特异度及敏感度分别为75.00%和78.33%、81.25%和66.67%、56.25%和70.00%。37例恶性肿瘤的DVP参数图像表现为不规则片状红/黄色区域,40例恶性肿瘤DVP曲线波相为正向波;23例良性肿瘤的DVP参数图像表现为单一的片状蓝色区域,18例良性肿瘤DVP曲线波相为负向波。结论Sonazoid超声造影定量分析鉴别诊断乳腺良、恶性肿瘤具有较好的效能。

Purpose To investigate the value of Sonazoid ultrasonography quantitative analysis in the differential diagnosis of benign and malignant breast tumors.Materials and Methods A total of 92 patients with 92 lesions who underwent ultrasonography of breast nodules from October 2021 to July 2022 in Department of Ultrasound,Beijing Hospital were retrospectively included.All subjects were divided into benign group(n=32)and malignant group(n=60)based on the gold standard of puncture or surgical pathology results.All images were quantitatively analyzed via SonoLiver software to obtain the maximum intensity(IMAX),rise time(RT),time to peak(TTP),mean transit time(mTT)and area under the curve(AUC)of the overall curve.Dynamic vascular pattern(DVP)images and DVP curves of the lesions were further obtained to analyze their differences in benign and malignant breast tumors,and to perform subject receiver operating characteristic curve for the five quantitative parameters,and to obtain cut-off values for the differential diagnosis of benign and malignant breast tumors.Results Compared with benign group,malignant group had significantly higher IMAX and AUC,and significantly lower m TT(Z=-4.443,-3.500,-2.226,all P<0.05).There were no significant differences in RT and TTP between benign group and malignant group(P>0.05).When IMAX>119.38%,AUC>54854%/s and mTT<70.59 s considered as cut-off values,the specificity and sensitivity of IMAX,AUC and MTT for the differential diagnosis of benign and malignant breast tumors were 75.00%vs.78.33%,81.25%vs.66.67%,56.25%vs.70.00%,respectively.There were 37 malignant tumors showed irregular sheet-like red/yellow areas on the DVP parameter images,40 malignant tumors with positive wave phase of the DVP curve,23 benign tumors with a single sheet-like blue area on the DVP parameter images,and 18 benign tumors with negative wave phase of the DVP curve.Conclusion Sonazoid ultrasonography quantitative analysis has good diagnostic efficacy for differentiating benign breast tumors from malignant breast tumors.