Objective:To explore the value and effect of contrast-enhanced ultrasound in the diagnosis of breast lesions.Methods:Seventy-two patients with breast lesions in Shaanxi Provincial People’s Hospital from June 2020 to ...Objective:To explore the value and effect of contrast-enhanced ultrasound in the diagnosis of breast lesions.Methods:Seventy-two patients with breast lesions in Shaanxi Provincial People’s Hospital from June 2020 to December 2021 were selected as the research subjects.All 72 patients met the diagnostic criteria of breast lesions.Two patients with incomplete clinical data were excluded;hence,there were 70 patients remaining.The diagnostic results of the two examination methods and the diagnostic value of the joint examination for breast lesions were analyzed and compared.Results:The results of benign,malignant,missed,and misdiagnosed breast lesions by contrast-enhanced ultrasound were 31,32,6,and 1 cases,respectively,accounting for 44.29%,45.71%,8.57%,and 1.43%,respectively.The results of benign,malignant,missed,and misdiagnosed breast lesions by ultrasound automatic volume imaging were 21,24,17,and 8 cases,respectively,accounting for 30.00%,34.28%,24.29%,and 11.43%,respectively.There were statistical differences between the two groups for missed diagnosis and misdiagnosis,but there was no significant difference between the two groups for benign and malignant lesions.The accuracy,sensitivity,and specificity of contrast-enhanced ultrasound were 87.69%,83.62%,and 83.45%,respectively;the accuracy,sensitivity,and specificity of ultrasound automatic volume imaging were 71.39%,68.99%,and 74.69%,respectively;the accuracy,sensitivity,and specificity of contrast-enhanced ultrasound combined with ultrasound automatic volume imaging were 96.29%,92.68%,and 91.78%,respectively.Conclusion:Contrast-enhanced ultrasonography has a high clinical application value and a low inspection error rate in the diagnosis of breast lesions.It merits clinical advancement since it helps doctors diagnose and treat breast lesions more effectively.展开更多
In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid ...In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity curve.The pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them（kappa 〈0.20）. In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions.展开更多
目的对比磁共振酰胺质子转移(Amide Proton Transfer,APT)成像、扩散加权成像(Diffusion Weighted Imaging,DWI)和动态增强(Dynamic Contrast-Enhanced,DCE)成像以及3者联合应用在鉴别乳腺良恶性病变中的诊断价值。方法纳入55例乳腺疾...目的对比磁共振酰胺质子转移(Amide Proton Transfer,APT)成像、扩散加权成像(Diffusion Weighted Imaging,DWI)和动态增强(Dynamic Contrast-Enhanced,DCE)成像以及3者联合应用在鉴别乳腺良恶性病变中的诊断价值。方法纳入55例乳腺疾病患者,均进行APT、DWI以及DCE扫描,测量非对称磁化转移(Magnetization Transfer Asymmetry,MTRasym)率和表观扩散系数(Apparent Diffusion Coefficient,ADC)值,并记录乳腺影像报告和数据系统的分类。分析乳腺良恶性病变各参数之间的差异,使用Logistic回归建立联合诊断模型,采用受试者工作特征曲线(Receive Operating Characteristic,ROC)计算各诊断模型在乳腺良恶性病变中的诊断价值,并比较恶性病变中不同病理因素组间的差异以及各病理因素与APT之间的相关性。结果恶性组中MTRasym和ADC值均小于良性组,差异具有统计学意义(均P<0.05),DWI、APT、DCE以及APT+DCE、APT+DWI、DCE+DWI、DWI+APT+DCE联合模型鉴别乳腺良恶性病变的曲线下面积(Area Under Curve,AUC)分别为0.804、0.723、0.741以及0.782、0.895、0.897、0.970;DWI+APT+DCE联合诊断模型的AUC显著大于DWI、APT、DCE以及任意两者联合诊断模型(均P<0.05)。Ki-67高表达组的MTRasym值较低表达组高[(3.934%±0.883%)v s.(3.192%±0.949%)],乳腺癌浸润程度组织学分级Ⅲ级组的M T R a s y m值较Ⅱ级组高[(4.225%±0.932%)vs.(3.451%±0.873%)],差异均有统计学意义(均P<0.05),并且APT与两者均呈中度正相关(r=0.627、0.537,均P<0.05)。结论APT成像技术在乳腺良恶性病变的鉴别中具有较好的诊断价值,与常规DWI、DCE成像无显著差异,并且三者联合应用的诊断价值更高。展开更多
文摘Objective:To explore the value and effect of contrast-enhanced ultrasound in the diagnosis of breast lesions.Methods:Seventy-two patients with breast lesions in Shaanxi Provincial People’s Hospital from June 2020 to December 2021 were selected as the research subjects.All 72 patients met the diagnostic criteria of breast lesions.Two patients with incomplete clinical data were excluded;hence,there were 70 patients remaining.The diagnostic results of the two examination methods and the diagnostic value of the joint examination for breast lesions were analyzed and compared.Results:The results of benign,malignant,missed,and misdiagnosed breast lesions by contrast-enhanced ultrasound were 31,32,6,and 1 cases,respectively,accounting for 44.29%,45.71%,8.57%,and 1.43%,respectively.The results of benign,malignant,missed,and misdiagnosed breast lesions by ultrasound automatic volume imaging were 21,24,17,and 8 cases,respectively,accounting for 30.00%,34.28%,24.29%,and 11.43%,respectively.There were statistical differences between the two groups for missed diagnosis and misdiagnosis,but there was no significant difference between the two groups for benign and malignant lesions.The accuracy,sensitivity,and specificity of contrast-enhanced ultrasound were 87.69%,83.62%,and 83.45%,respectively;the accuracy,sensitivity,and specificity of ultrasound automatic volume imaging were 71.39%,68.99%,and 74.69%,respectively;the accuracy,sensitivity,and specificity of contrast-enhanced ultrasound combined with ultrasound automatic volume imaging were 96.29%,92.68%,and 91.78%,respectively.Conclusion:Contrast-enhanced ultrasonography has a high clinical application value and a low inspection error rate in the diagnosis of breast lesions.It merits clinical advancement since it helps doctors diagnose and treat breast lesions more effectively.
基金supported by the Natural Science Foundation of Jiangsu University(14KJB320003)
文摘In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity curve.The pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them（kappa 〈0.20）. In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions.
文摘目的对比磁共振酰胺质子转移(Amide Proton Transfer,APT)成像、扩散加权成像(Diffusion Weighted Imaging,DWI)和动态增强(Dynamic Contrast-Enhanced,DCE)成像以及3者联合应用在鉴别乳腺良恶性病变中的诊断价值。方法纳入55例乳腺疾病患者,均进行APT、DWI以及DCE扫描,测量非对称磁化转移(Magnetization Transfer Asymmetry,MTRasym)率和表观扩散系数(Apparent Diffusion Coefficient,ADC)值,并记录乳腺影像报告和数据系统的分类。分析乳腺良恶性病变各参数之间的差异,使用Logistic回归建立联合诊断模型,采用受试者工作特征曲线(Receive Operating Characteristic,ROC)计算各诊断模型在乳腺良恶性病变中的诊断价值,并比较恶性病变中不同病理因素组间的差异以及各病理因素与APT之间的相关性。结果恶性组中MTRasym和ADC值均小于良性组,差异具有统计学意义(均P<0.05),DWI、APT、DCE以及APT+DCE、APT+DWI、DCE+DWI、DWI+APT+DCE联合模型鉴别乳腺良恶性病变的曲线下面积(Area Under Curve,AUC)分别为0.804、0.723、0.741以及0.782、0.895、0.897、0.970;DWI+APT+DCE联合诊断模型的AUC显著大于DWI、APT、DCE以及任意两者联合诊断模型(均P<0.05)。Ki-67高表达组的MTRasym值较低表达组高[(3.934%±0.883%)v s.(3.192%±0.949%)],乳腺癌浸润程度组织学分级Ⅲ级组的M T R a s y m值较Ⅱ级组高[(4.225%±0.932%)vs.(3.451%±0.873%)],差异均有统计学意义(均P<0.05),并且APT与两者均呈中度正相关(r=0.627、0.537,均P<0.05)。结论APT成像技术在乳腺良恶性病变的鉴别中具有较好的诊断价值,与常规DWI、DCE成像无显著差异,并且三者联合应用的诊断价值更高。
