常规超声联合S-Detect在BI-RADS 4类结节中的诊断价值

The Diagnostic Value of Conventional Ultrasound Combined with S-Detect in BI-RADS 4 Nodules

目的:探讨超声S-Detect技术对不同大小乳腺结节良恶性的鉴别诊断价值。方法:收集2019年10月—2022年10月于宜昌市中心人民医院就诊的乳腺BI-RADS 4类结节的412例患者(共456个结节),以病理检查结果为金标准,通过比较受试者工作特征曲线(ROC)、敏感度(SE)、特异度(SP)、准确度(ACC)、阳性预测值(PPV)及阴性预测值(NPV),评价常规超声、S-Detect、常规超声+S-Detect对乳腺BI-RADS 4类结节的诊断价值。结果:456个BI-RADS 4类结节,经病理证实恶性结节200个,良性结节256个。与常规超声和S-Detect相比,常规超声+S-Detect的诊断效能明显提高(均P<0.05)。对于最大直径≤20 mm的乳腺BI-RADS 4类结节,常规超声+S-Detect联合检测的SE、SP、ACC、PPV、NPV、曲线下面积(AUC)分别为:91.96%、95.12%、94.01%、91.15%、95.59%、0.935;对于最大直径>20 mm的乳腺BI-RADS 4类结节,常规超声+S-Detect联合检测的SE、SP、ACC、PPV、NPV、AUC分别为:98.86%、90.20%、96.40%、94.57%、97.87%、0.945。结论:常规超声联合S-Detect对不同大小BI-RADS 4类乳腺结节良恶性判断具有较高的鉴别诊断价值。

Objective:To explore the diagnostic value of S-Detect technology in differentiating benign from malignant breast nodules of various sizes.Methods:A total of 412 patients(456 nodules)with Breast Imaging Reporting and Data System(BI-RADS)category 4 nodules who visited Yichang Central People's Hospital between October 2019 and October 2022 were collected.The pathological examination results were used as the gold standard.By comparing the receiver operating characteristic curve(ROC),sensitivity(SE),specificity(SP),accuracy(ACC),positive predictive value(PPV),and negative predictive value(NPV),the diagnostic value of conventional ultrasound,S-Detect,and conventional ultrasound combined with S-Detect for BI-RADS category 4 nodules was evaluated.Results:Of the 456 BI-RADS category 4 nodules,200 were confirmed malignant and 256 benign by pathology.Compared with conventional ultrasound and S-Detect alone,the diagnostic efficacy of conventional ultrasound combined with S-Detect was significantly improved(all P<0.05).For BI-RADS category 4 nodules with a maximum diameter≤20 mm,the SE,SP,ACC,PPV,NPV,and AUC of combined conventional ultrasound and S-Detect were 91.96%,95.12%,94.01%,91.15%,95.59%and 0.935,respectively.For BI-RADS category 4 nodules with a maximum diameter>20 mm,the corresponding values were 98.86%,90.20%,96.40%,94.57%,97.87%and 0.945,respectively.Conclusion:Conventional ultrasound combined with S-Detect has a high diagnostic value in differentiating the benign and malignant of BI-RADS category 4 breast nodules of various sizes.