实时超声弹性成像技术与DCE-MRI在乳腺结节良恶性鉴别诊断中的应用价值

Application value of real-time ultrasonic elastography and DCE-MRI in the differential diagnosis of benign and malignant breast nodules

目的观察实时超声弹性成像技术(UE)与磁共振动态增强(DCE-MRI)在乳腺结节良恶性鉴别诊断中的应用价值。方法选择2020年1月至2022年6月临汾市中心医院收治的150例乳腺结节患者为研究对象,均行UE及DCE-MRI检查,以术后病理诊断结果为金标准,比较UE、DCE-MRI及两者联合诊断对乳腺结节良恶性鉴别的价值。结果150例患者中,经手术病理结果发现175个乳腺结节,其中138个良性病变(纤维腺瘤38个、乳腺病31个、乳腺炎42个、脂肪瘤25个、单纯性囊肿2个),37个恶性病变(浸润性导管癌21个、乳头状癌9个、小叶原位癌5个、导管内癌2个)。恶性乳腺结节的患者中,UE成像评分≥4分的比例为72.97%,高于良性结节的8.69%(χ^(2)=69.603,P<0.05),且K^(trans)与V_(e)值均高于良性结节患者(t值分别为13.400、11.755,P<0.05);UE联合DCE-MRI检查的敏感性及准确性分别为94.59%、93.14%,均高于单一检查组,差异有统计学意义(P<0.05)。结论UE联合DCE-MRI检查能显著提高乳腺结节良恶性鉴别的诊断效能,其敏感性及准确性较高。

Objective To observe the application value of real-time ultrasound elastography(UE)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the differential diagnosis of benign and malignant breast nodules.Methods A total of 150 patients with breast nodules admitted to Linfen Central Hospital from January 2020 to June 2022 were selected as the study objects,and all of them were examined by UE and DCE-MRI,the postoperative pathological diagnosis results were used as the golden standard to compare the value of UE,DCE-MRI and the combination of the two in the benign and malignant differential diagnosis of breast nodules.Results Among 150 patients,surgical pathology showed that there were 175 breast nodules,including 138 benign lesions(38 fibroadenomas,31 mastopathies,42 mastitis,25 lipomas,2 simple cysts)and 37 malignant lesions(21 invasive ductal carcinoma,9 papillary carcinoma,5 lobular carcinoma in situ,2 intraductal carcinoma).The proportion of UE score≥4 in malignant nodules was 72.97%,significantly higher than that in benign nodules,which was 8.69%(χ^(2)=69.603,P<0.05),and the K^(trans) and V_(e) were significantly greater than those in benign nodules(t=13.400 and 11.755,respectively,P<0.05).The sensitivity of UE in combination with DCE-MRI and accuracy were 94.59%and 93.14%,respectively,which were significantly higher than those of single index,with a statistically significant difference(P<0.05).Conclusion UE combined with DCE-MRI can significantly improve the diagnosis efficiency of benign and malignant breast nodules,with high sensitivity and accuracy.