CEUS联合2DUS对乳腺良恶性病变的诊断价值

The diagnostic value of CEUS combined with 2DUS in the diagnosis of differentiating benign and malignant breast lesions

目的:以病理学检查为“金标准”,探讨超声造影(contrast-enhanced ultrasound,CEUS)联合二维超声(2D ultrasound,2DUS)对乳腺良恶性病变的鉴别诊断价值。方法:收集2018年2月—2023年8月于同济大学附属第十人民医院行乳腺2DUS及CEUS检查并经病理学检查确诊的1 299例女性乳腺病变患者。患者进行2DUS乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)分类和CEUS联合2DUS检查,对比分析乳腺良恶性病变的CEUS特征,以及两种检查方式下的灵敏度、特异度、准确度、阳性预测值和阴性预测值。结果:根据病理学检查结果将1 299例患者分为良性病变组807例和恶性病变组492例,与2DUS BI-RADS分类检查相比较,CEUS联合2DUS检查的灵敏度(96.1%)及准确度(88.8%)均明显提高,并且针对BI-RADS 4类病变良恶性检出具有较高的灵敏度(95.9%)。结论:CEUS联合2DUS能够显著提高对乳腺良恶性病变的鉴别诊断效能,具有较高的诊断价值。

Objective:To assess the diagnostic accuracy of contrast-enhanced ultrasound(CEUS)in conjunction with 2D ultrasound(2DUS)in the diagnosis of the breast benign and malignant lesions,with pathological histological analysis serving as the gold standard.Methods:A total of 1299 female breast lesions patients who underwent breast 2DUS and CEUS in Tenth People’s Hospital of Tongji University from February 2018 to August 2023,with pathological histological examination were included in this study,and patients underwent examination with 2DUS Breast Imaging Reporting and Data System(BI-RADS)and CEUS combined with 2DUS,and were compared and analyzed for the CEUS features of breast benign and malignant lesions as well as the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value under the two examination modalities.Results:Based on the findings from pathological histological examinations,the 1299 patients were distributed into two groups,with 807 cases falling under the benign lesion group and 492 cases classified as malignant lesions group.2DUS BIRADS and CEUS combined with 2DUS examination were performed respectively,the sensitivity(96.1%)and accuracy rate(88.8%)of CEUS combined with 2DUS examination was significantly higher than the 2DUS BI-RADS examination,which suggested that the diagnostic value of CEUS combined with 2DUS was higher,and it also had a high sensitivity(95.9%)for the detection of benign and malignant 4 types of BI-RADS lesions.Conclusion:CEUS combined with 2DUS can be used together in the differential diagnosis of breast benign and malignant lesions,and the combined detection of the two has a high diagnostic value and can improve the diagnostic accuracy.