超声造影检查定量参数联合检测在乳腺非肿块样强化病变良恶性鉴别诊断中的应用价值

Application value of combined detection of quantitative parameters of contrast-enhanced ultrasound in differential diagnosis of benign and malignant non-mass-like enhancement breast lesions

目的:观察超声造影检查定量参数联合检测在乳腺非肿块样强化病变良恶性鉴别诊断中的应用价值。方法:选取2021年4月至2023年4月该院收治的118例乳腺非肿块样强化病变患者进行前瞻性研究,患者均行超声造影检查,以术后病理结果为“金标准”,将患者分为良性组(n=49)、恶性组(n=69),比较两组超声造影检查影像学表现和定量参数(时间-强度曲线峰值强度、达峰时间、上升时间、平均通过时间、从峰值将至一半时间、曲线下面积),采用受试者工作特征(ROC)曲线分析超声造影检查定量参数中峰值强度、达峰时间、曲线下面积联合检测在乳腺非肿块样强化病变良恶性鉴别诊断中的价值。结果:恶性组不均匀增强、高增强、伴穿支血管、增强后病灶扩大、造影剂快进慢退发生率均高于良性组,差异有统计学意义(P<0.05);恶性组峰值强度高于对照组,曲线下面积大于对照组,达峰时间短于对照组,差异均有统计学意义(P<0.05);两组上升时间、平均通过时间、从峰值降至一半时间比较,差异均无统计学意义(P>0.05);ROC曲线结果显示,峰值强度、达峰时间、曲线下面积单项及联合检测鉴别诊断乳腺非肿块样强化病变良恶性的曲线下面积分别为0.774、0.748、0.818、0.935,联合检测诊断价值高于三者单项检测诊断价值。结论:超声造影定量参数中峰值强度、达峰时间、曲线下面积联合检测鉴别诊断乳腺非肿块样强化病变良恶性的价值高于三者单项检测。

Objective:To observe application value of combined detection of quantitative parameters of contrast-enhanced ultrasound in differential diagnosis of benign and malignant non-mass-like enhancement breast lesions.Methods:A prospective study was conducted on 118 patients with non-mass-like enhanced breast lesions admitted to the hospital from April 2021 to April 2023.All patients underwent contrast-enhanced ultrasonography.According to the postoperative pathological results,these patients were divided into benign group(n=49)and malignant group(n=69).The imaging findings and the quantitative parameters(time-intensity curve peak intensity,time to peak,rise time,mean transit time,time from peak to half,area under the curve)of contrast-enhanced ultrasound were compared between the two groups.The receiver operator characterist(ROC)curve was used to analyze the value of combined detection of peak intensity,time to peak and area under curve in the differential quantitative parameters of contrast-enhanced ultrasound in the diagnosis of benign and malignant non-mass-like enhancement breast lesions.Results:The proportions of uneven enhancement,high enhancement,with perforator vessels,enlarged lesions after enhancement,and contrast agent fast advance and slow regression in the malignant group were higher than those in the benign group,and the differences were statistically significant(P<0.05).The peak intensity of the malignant group was higher than that of the control group,the area under the curve was larger than that of the control group,the time to peak was shorter than that of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the rise time,mean transit time,time from peak to half between the two groups(P>0.05).The ROC curve showed that the area under the curve of single detection of peak intensity,time to peak,area under the curve and combined detection in the differential diagnosis of benign and malignant breast non-mass-like enhancement lesions were 0.774,0.748,0.818 and 0.935,separately.The diagnostic value of combined detection was higher than that of single detection.Conclusions:The value of combined detection of peak intensity,time to peak and area under curve in the quantitative parameters of contrast-enhanced ultrasound in the differential diagnosis of benign and malignant breast non-mass-like enhancement lesions is higher than that of single detection of the three.