乳腺囊实混合性肿块的多模态超声特征分型及良恶性鉴别

Multimodal ultrasound characteristic typing and differential diagnosis of benign and malignant breast complex cystic and solid masses

目的:探讨多模态超声特征分型在乳腺囊实混合性肿块良恶性鉴别诊断中的价值。方法:回顾性分析106例经病理证实的乳腺囊实混合性肿块(108个),术前行常规超声、萤火虫成像、超微血管三维成像(Smart 3D SMI)及应变弹性成像(SE)。应用多模态超声对肿块特征分型,并对常规超声的乳腺影像报告和数据系统(BI-RADS)分类结果进行校正。以术后病理为金标准,比较分析校正前后的鉴别诊断效能。结果:106例中良性61例(62个病灶),恶性45例(46个病灶)。常规超声BI-RADS分类结果校正后的诊断敏感度、特异度、准确率、阳性预测值、阴性预测值、AUC分别为89.13%、80.65%、84.26%、77.36%、90.91%、0.849,均高于校正前。结论:常规超声BI-RADS分类经多模态超声校正后,可提高对乳腺囊实混合性肿块良恶性的鉴别诊断效能。

Objective:To explore the value of multimodal ultrasound feature typing in the differential diagnosis of benign and malignant breast complex cystic and solid masses.Methods:A total of 106 patients(108 lesions)with breast complex cystic and solid masses were analyzed retrospectively.All patients underwent routine ultrasound,MicroPure imaging,smart 3D superb microvascular imaging(Smart 3D SMI)and strain elastography(SE).Multimodal ultrasound was used to classify the characteristics of the masses,and the classification results of routine ultrasound BI-RADS were corrected.Postoperative pathology was taken as the gold standard to compare and analyze the differential diagnostic efficacy before and after correction.Results:Among the 106 cases,61 cases were benign(62 lesions)and 45 cases were malignant(46 lesions).The diagnostic sensitivity,specificity,accuracy,positive predictive value,negative predictive value and AUC after the correction of conventional ultrasound BI-RADS classification results were 89.13%,80.65%,84.26%,77.36%,90.91%and 0.849,respectively,which were higher than those before the correction.Conclusion:According to the results of multimodal ultrasound classification of breast complex cystic and solid masses,the classification of conventional ultrasound BI-RADS is helpful for distinguishing between benign and malignant lesions.