Correlation of contrast-enhanced ultrasound parameters with oncogene expression and cell proliferation activity in breast cancer

Objective: To study the correlation of contrast-enhanced ultrasound parameters with oncogene expression and cell proliferation activity in breast cancer. Methods: Breast cancer lesions and benign breast lesions surgically removed in Zigong Third People's Hospital between May 2014 and February 2017 were selected, contrast-enhanced ultrasound was done before operation to draw the time-intensity curve and calculate the area under the curve (AUC), and the expression of proliferation molecules and tumor suppressor genes were detected after operation. Results:The contrast-enhanced ultrasound parameter AUC of the breast cancer lesion was greatly higher than that of the benign breast lesion;ECT2, ZKSCAN3, USP39 and EphA2 mRNA expression in breast cancer lesions were obviously higher than those in benign breast lesions whereas HPK1, TCEAL17, CCN5, ATG2B and ATG4D mRNA expression were greatly lower than those in benign breast lesions;ECT2, ZKSCAN3, USP39 and EphA2 mRNA expression in breast cancer lesions with high AUC were greatly higher than those in breast cancer lesions with low AUC whereas HPK1, TCEAL17, CCN5, ATG2B and ATG4D mRNA expression were greatly lower than those in breast cancer lesions with low AUC. Conclusion: The contrast-enhanced ultrasound parameter AUC of breast cancer lesion significantly increases and is closely related to the higher expression of pro-proliferation molecules and the lower expression of tumor suppressor genes.

Assessment value of contrast-enhanced ultrasound parameters for the nature of breast tumor and their relationship with the malignant biological behavior of tumor

Objective: To discuss the value of contrast-enhanced ultrasound parameters for assessing the nature of breast tumor and their relationship with the malignant biological behavior of tumor. Methods: A total of 176 patients with breast tumor who received surgical treatment in the hospital between January 2015 and January 2017 were divided into breast adenoma group (n=110) and breast cancer group (n=66) according to pathological results. The differences in breast contrast-enhanced ultrasound parameter levels as well as the expression of proliferation, invasion and autophagy genes in tumor tissues were compared between the two groups of patients. Pearson test was used to evaluate the correlation between contrast-enhanced ultrasound parameters and malignant molecule expression in lesion tissue of patients with breast cancer. Results: PI and AUC levels in breast cancer group were greatly higher than those in breast adenoma group;proliferation genes CXCL1 and Notch1 mRNA expression in tumor tissue were higher than those of breast adenoma group whereas HPK1 mRNA expression was lower than that of breast adenoma group;invasion genes Gab2, NUAK1 and FOXF1 mRNA expression in tumor tissue were higher than those of breast adenoma group whereas NDRG1 mRNA expression was lower than that of breast adenoma group;autophagy genes ATG2B, ATG4D and ATG9B mRNA expression in tumor tissue were lower than those of breast adenoma group. Pearson test showed that the contrast-enhanced ultrasound parameters PI and AUC levels in patients with breast cancer were directly correlated with the expression of proliferation, invasion and autophagy molecules in the lesion tissue. Conclusion: The contrast-enhanced ultrasound parameter levels in patients with breast cancer are different from those in patients with benign tumors, and the specific parameter levels are directly correlated with the tumor malignancy and can be used as the reliable means for early disease screening and malignancy assessment.

Contrast-enhanced ultrasound improved performance of breast imaging reporting and data system evaluation of critical breast lesions

AIM: To determine whether contrast-enhanced ultrasound(CEUS) can improve the precision of breast imaging reporting and data system(BI-RADS) categorization. METHODS: A total of 230 patients with 235 solid breast lesions classified as BI-RADS 4 on conventional ultrasound were evaluated. CEUS was performed within one week before core needle biopsy or surgical resection and a revised BI-RADS classification was assigned based on 10 CEUS imaging characteristics. Receiver operating characteristic curve analysis was then conducted to evaluate the diagnostic performance of CEUS-based BI-RADS assignment with pathological examination as reference criteria. RESULTS: The CEUS-based BI-RADS evaluation classified 116/235(49.36%) lesions into category 3, 20(8.51%), 13(5.53%) and 12(5.11%) lesions into categories 4A, 4B and 4C, respectively, and 74(31.49%) into category 5. Selecting CEUS-based BI-RADS category 4A as an appropriate cut-off gave sensitivity and specificity values of 85.4% and 87.8%, respectively, for the diagnosisof malignant disease. The cancer-to-biopsy yield was 73.11% with CEUS-based BI-RADS 4A selected as the biopsy threshold compared with 40.85% otherwise, while the biopsy rate was only 42.13% compared with 100% otherwise. Overall, only 4.68% of invasive cancers were misdiagnosed.CONCLUSION: This pilot study suggests that evaluation of BI-RADS 4 breast lesions with CEUS results in reduced biopsy rates and increased cancer-to-biopsy yields.

Predictive model for contrast-enhanced ultrasound of the breast: Is it feasible in malignant risk assessment of breast imaging reporting and data system 4 lesions?

AIM: To build and evaluate predictive models for contrast-enhanced ultrasound(CEUS) of the breast to distinguish between benign and malignant lesions. METHODS: A total of 235 breast imaging reporting and data system(BI-RADS) 4 solid breast lesions were imaged via CEUS before core needle biopsy or surgical resection. CEUS results were analyzed on 10 enhancing patterns to evaluate diagnostic performance of three benign and three malignant CEUS models, with pathological results used as the gold standard. A logistic regression model was developed basing on the CEUS results, and then evaluated with receiver operating curve(ROC). RESULTS: Except in cases of enhanced homogeneity, the rest of the 9 enhancement appearances were statistically significant(P < 0.05). These 9 enhancement patterns were selected in the final step of the logistic regression analysis, with diagnostic sensitivity and specificity of 84.4% and 82.7%, respectively, and the area under the ROC curve of 0.911. Diagnostic sensitivity, specificity, and accuracy of the malignant vs benign CEUS models were 84.38%, 87.77%, 86.38% and 86.46%, 81.29% and 83.40%, respectively. CONCLUSION: The breast CEUS models can predict risk of malignant breast lesions more accurately, decrease false-positive biopsy, and provide accurate BIRADS classification.

Diagnostic performance of contrast-enhanced ultrasound and enhanced magnetic resonance for breast nodules

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.

Contrast-enhanced ultrasound:The evolving applications

Contrast-enhanced ultrasound(CEUS)is a major breakthrough for ultrasound imaging in recent years.By using a microbubble contrast agent and contrast-specific imaging software,CEUS is able to depict the microand macro-circulation of the targeted organ,which in turn leads to improved performance in diagnosis.Due to the special dual blood supply system in the liver,CEUS is particularly suitable for liver imaging.It is evident that CEUS facilitates improvement for characterization of focal liver lesions(FLLs),detection of liver malignancy,guidance for interventional procedures,and evaluation of treatment response after local therapies.CEUS has been demonstrated to be equal to contrast-enhanced computed tomography or magnetic resonance imaging for the characterization of FLLs.In addition,the applicability of CEUS has expanded to non-liver structures such as gallbladder,bile duct,pancreas,kidney,spleen,breast,thyroid,and prostate.The usefulness of CEUS in these applications is confirmed by extensive literature production.Novel applications include detecting bleeding sites and hematomas in patients with abdominal trauma,guiding percutaneous injection therapy and therefore achieving the goal of using interventional ultrasonography in managing splenic trauma,assessing the activity of Crohn’s disease,and detecting suspected endoleaks after endovascular abdominal aneurysm repair.Contrast-enhanced intraoperative ultrasound(US)and intracavitary use of CEUS have been developed and clinically studied.The potential use of CEUS involves sentinel lymph node detection,drug or gene delivery,and molecular imaging.In conclusion,the advent of CEUS has greatly enhanced the usefulness of US and even changed the status of US in clinical practice.The application of CEUS in the clinic is continuously evolving and it is expected that its use will be expanded further in the future.

Advantages of contrast-enhanced ultrasound in the localization and diagnostics of sentinel lymph nodes in breast cancer

Sentinel lymph nodes(SLNs)are the first station of lymph nodes that extend from the breast tumor to the axillary lymphatic drainage.The pathological status of these LNs can predict that of the entire axillary lymph node.Therefore,the accurate identification of SLNs is necessary for sentinel lymph node biopsy(SLNB)to replace axillary lymph node dissection(ALND).The quality of life and prognosis of breast cancer patients are related to proper surgical treatment after the precise identification of SLNs.Some of the SLN tracers that have been identified include radioisotope,nano-carbon,indocyanine green(ICG),and methylene blue(MB).However,these tracers have certain limitations,such as pigmentation,radiation dangers,and the requirement for costly detection equipment.Ultrasound contrast agents(UCAs)have good specificity and sensitivity,and thus can compensate for some shortcomings of the mentioned tracers.This technique is also being applied to SLNB in patients with breast cancer,and can even provide an initial judgment on SLN status.Contrast-enhanced ultrasound(CEUS)has the advantages of high distinguishability,simple operation,no radiation harm,low cost,and accurate localization;therefore,it is expected to replace the traditional biopsy methods.In addition,it can significantly enhance the accuracy of SLN localization and shorten the operation time.

Correlation of quantitative perfusion parameters on dynamic contrast-enhanced MRI with prognostic factors and subtypes of breast carcinoma

Objective To investigate whether correlation existsbetween quantitative perfusion parameters obtained from dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and different prognostic factors or immunohistochemical subtypes of breast cancers.Methods A retrospective analysis of DCE-MRI was performed in

多参数MRI与实时组织超声弹性成像在乳腺肿瘤中的诊断价值

目的探讨多参数磁共振(Magnetic resonance imaging,MRI)与实时组织超声弹性成像(Real time tissue ultrasound elastography,RTE)在乳腺肿瘤中的诊断价值。方法选取2021年10月-2023年5月泰安市立医院收治的338例乳腺肿瘤患者为研究对象,其中乳腺恶性肿瘤169例作为恶性组,乳腺良性肿瘤169例作为良性组。所有患者均接受多参数MRI与RTE检查,统计恶性组与良性组、恶性组不同病理特征患者多参数MRI、RTE检查参数,比较多参数MRI检查、RTE检查联合多参数MRI与RTE(联合检查)对乳腺肿瘤的鉴别诊断效能以及与乳腺癌病理特征的关联性。结果恶性组平均扩散率(Mean diffusivity,MD)、扩散系数(Diffusion coefficient,D)低于良性组,平均扩散峰度值(Average diffusion kurtosis value,MK)、灌注分数(Perfusion fraction,f)、容积转运参数(Volume transfer parameters,K^(trans))、速率常数(Rate constant,K_(ep))、血管外细胞外容积分数(Extracellular volume fraction of blood vessels,V-e)、RTE评分高于良性组,差异有统计学意义(P<0.05)。联合检查对乳腺癌的诊断敏感度、准确度(97.04%、95.56%)高于多参数MRI(84.02%、89.35%)与RTE(82.25%、88.76%)单独检查,差异有统计学意义(P<0.05);联合检查特异度(94.08%)与多参数MRI检查(94.67%)、RTE检查(95.27%)比较,差异无统计学意义(P>0.05)。淋巴结转移、Ⅲ~Ⅳ期乳腺癌患者MD、D低于无淋巴结转移、Ⅰ~Ⅱ期患者,MK、f、K^(trans)、K_(ep)、V-e、RTE评分高于无淋巴结转移、Ⅰ~Ⅱ期患者,差异有统计学意义(P<0.05)。MD、D与乳腺癌淋巴结转移、疾病分期呈负相关,MK、f、K^(trans)、K_(ep)、V-e、RTE与乳腺癌淋巴结转移、疾病分期呈正相关(P<0.05)。结论多参数MRI与RTE单一检查均可诊断乳腺肿瘤良恶性,但二者联合检查可进一步提升诊断准确性,同时评估疾病病理特征,为疾病干预方案的制定提供参考依据。

二维超声及彩色多普勒超声对乳腺良恶性结节的诊断价值研讨

目的研究二维超声及彩色多普勒超声临床应用价值,分析其在乳腺良恶性结节诊断中的效果。方法随机选取2022年1月—2023年3月济宁市兖州区人民医院收治的60例乳腺结节患者为研究对象,以手术病理诊断为金标准,实施二维超声、彩色多普勒超声,对不同诊断方案的价值进行评估。结果病理诊断显示良性40例,恶性20例;彩色多普勒超声诊断良性41例,恶性19例;二维超声诊断良性47例,恶性13例。彩色多普勒超声灵敏度、准确度均高于二维超声,差异有统计学意义(P均<0.05);彩色多普勒超声对不同类型乳腺结节的诊断符合率高于二维超声,差异有统计学意义(P<0.05)。结论彩色多普勒超声诊断具有较高的灵敏度、特异度、准确度,且对良恶性结节的鉴别诊断以及不同类型乳腺结节的检出有积极意义,可以指导后续针对性治疗措施的实施。

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

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。

超声血流参数联合血清CXCL8、IL-1β、IL-10诊断乳腺癌的价值研究

目的探讨超声血流参数联合血清趋化因子配体8(CXCL8)、白细胞介素-1β(IL-1β)、白细胞介素-10(IL-10)诊断乳腺癌的价值。方法回顾性分析2021年1月—2023年1月三亚中心医院收治的170例乳腺癌患者的临床资料,将其作为乳腺癌组。另取同期该院170例乳腺良性肿瘤患者作为良性组。比较两组超声血流参数[搏动指数(PI)、阻力指数(RI)]及血清CXCL8、IL-1β、IL-10水平,比较不同临床病理特征乳腺癌患者的PI、RI、CXCL8、IL-1β、IL-10水平,绘制受试者工作特征(ROC)曲线分析PI、RI、CXCL8、IL-1β、IL-10单独及联合诊断乳腺癌的价值,采用多因素逐步Logistic回归模型分析PI、RI、CXCL8、IL-1β、IL-10与乳腺癌的关系。结果乳腺癌组PI、RI、CXCL8、IL-1β、IL-10水平均高于良性组(P<0.05)。临床分期Ⅲ、Ⅳ期,中低分化,淋巴结转移的乳腺癌患者PI、RI、CXCL8、IL-1β、IL-10水平分别高于临床分期Ⅰ、Ⅱ期,高分化,无淋巴结转移的患者(P<0.05)。ROC曲线分析结果表明,PI、RI、CXCL8、IL-1β、IL-10诊断乳腺癌的敏感性分别为75.3%(95%CI:0.724,0.791)、71.2%(95%CI:0.659,0.748)、82.4%(95%CI:0.792,0.886)、85.9%(95%CI:0.804,0.911)、75.3%(95%CI:0.711,0.789),特异性分别为87.1%(95%CI:0.831,0.902)、88.8%(95%CI:0.833,0.914)、85.9%(95%CI:0.816,0.897)、88.2%(95%CI:0.852,0.916)、89.4%(95%CI:0.847,0.922);PI、RI、CXCL8、IL-1β、IL-10联合诊断乳腺癌的敏感性为87.1%(95%CI:0.825,0.912),特异性为91.8%(95%CI:0.887,0.936),优于各项指标单独诊断。多因素逐步Logistic回归分析结果显示:PI≥1.185[O^R=1.753(95%CI:1.178,2.609)]、RI≥0.745[O^R=1.861(95%CI:1.199,2.889)]、CXCL8≥39.535 ng/mL[O^R=2.017(95%CI:1.288,3.159)]、IL-1β≥4.100 pg/mL[O^R=2.115(95%CI:1.304,3.430)]和IL-10≥31.205 pg/mL[O^R=2.344(95%CI:1.398,3.930)]是乳腺癌发生的危险因素(P<0.05)。结论PI、RI、CXCL8、IL-1β、IL-10对乳腺癌均有一定诊断价值,且联合检测诊断效能更高。

不同组织学分级乳腺癌老年患者超声造影参数及Ki67表达分析

目的分析不同组织学分级乳腺癌老年患者超声造影参数及增殖细胞核抗原(Ki67)表达。方法回顾性分析2018年1月—2022年1月于广安市人民医院收治的72例老年乳腺癌患者的临床资料(设为恶性组),选取同期36例老年良性乳腺肿瘤患者的临床资料作为对照(设为良性组)。所有患者均行超声造影检查,比较2组的超声造影参数。通过本院病例电子系统统计患者病理类型、组织学分级、Ki67表达。运用受试者工作特征曲线(ROC)评价达峰时间、增强幅度、上升支斜率和Ki67阳性表达率指标对老年乳腺癌患者的诊断价值。结果恶性组患者乳腺超声造影以树枝状或环状不均匀高增强为主,灌注方式主要以快进慢退及快进延迟慢退为主。恶性组患者达峰时间、增强幅度、上升支斜率、Ki67阳性表达率均明显高于良性组(P<0.05)。组织学分级为Ⅰ级和Ⅱ级的老年乳腺癌患者达峰时间、增强幅度、上升支斜率和Ki67阳性表达率均明显高于Ⅲ级(P<0.05),且Ⅰ级患者达峰时间、增强幅度、上升支斜率和Ki67阳性表达率均明显高于Ⅱ级(P<0.05)。ROC曲线分析显示,达峰时间、增强幅度、上升支斜率和Ki67阳性表达率指标诊断老年乳腺癌患者的AUC分别为0.622、0.707、0.674、0.736(均P<0.05);达峰时间、增强幅度、上升支斜率截断值分别为35.21 s、15.84 dB、9.70。以达峰时间、增强幅度、上升支斜率和Ki67阳性表达率为临界点,上述指标采用并联的方式进行联合检测诊断老年乳腺癌,其AUC为0.813,敏感度为90.28%,特异度为72.22%,联合检测AUC及敏感度均高于单项指标检测。结论不同组织学分级老年乳腺癌患者乳腺超声造影参数存在明显差异,其造影参数联合诊断对乳腺良、恶性病变具有一定的价值。

超声造影定量参数对Luminal型乳腺癌诊断价值及其与雄激素受体及Ki-67的相关性研究

目的:探讨超声造影定量参数在Luminal型乳腺癌诊断中的价值,分析Luminal型乳腺癌患者超声造影定量参数与其雄激素受体(AR)及肿瘤增殖细胞相关抗原Ki-67的相关性。方法:选取医院收治的90例Luminal型乳腺癌患者,并根据病理及免疫组化检测结果将其分为LuminalA型组(32例)和LuminalB型组(58例),比较两组患者超声造影表现差异及定量参数,同时比较定量参数与Ki-67及AR表达水平的相关性。结果:两组患者的超声造影增强强度、灌注缺损、增强边界及穿入血流表现比较,差异均有统计学意义(x^(2)=5.204,x^(2)=11.880,x^(2)=6.556,x^(2)=7.249;P<0.05)。LuminalB型组患者与LuminalA型组相比,病灶区域血流灌注的峰值强度(PI)上升,达峰时间(TTP)及平均渡越时间(TOF)下降,差异均有统计学意义(t=8.084,t=8.639,t=7.945;P<0.05)。LuminalA型组患者Ki-67及AR阳性检出率低于LuminalB型组,差异有统计学意义(x^(2)=4.224,x^(2)=4.262;P<0.05)。90例Luminal型乳腺癌患者PI与Ki-67和AR表达水平均呈正相关(r=0.159,r=0.657;P<0.05);TTP、TOF与Ki-67和AR表达水平均呈负相关(r=-0.537,r=-0.407;r=-0.503,r=-0.023;P<0.05)。结论:超声造影定量参数对Luminal型乳腺癌的临床诊断价值较高,并与AR、Ki-67具有一定的相关性,可用于对Luminal型乳腺癌状况变化的诊断评估。

多模态超声参数在鉴别乳腺病变性质中的应用价值

目的探讨多模态超声参数在鉴别乳腺病变性质中的应用价值。方法70例乳腺病变患者均接受多模态超声检查,分析超声参数诊断乳腺恶性病变的价值。结果多模态超声检查显示23例(32.85%)为恶性病变,准确率为95.83%(67/70)。恶性病变组的V_(max)、Vmean、VTI评分、E_(min)、E_(max)、PI均高于良性病变组(P<0.05)。V_(max)、Vmean、VTI评分、E_(min)、E_(max)、PI联合检测诊断乳腺恶性病变的AUC高于各参数单独检测(P<0.05)。结论多模态超声参数鉴别诊断乳腺病变良恶性的价值较高,各参数联合检测可提高乳腺恶性病变的诊断准确率。

超声血流定量参数联合弹性成像鉴别诊断BI-RADS 3~4类乳腺良恶性肿块的诊断价值

目的探究血流相关参数联合超声弹性成像(ultrasonic elastography,UE)鉴别诊断乳腺影像报告和数据系统分级(breast imaging reporting and data system,BI-RADS)3~4类乳腺良恶性肿块的诊断价值。方法回顾性分析2021年1月-2022年8月以“乳腺肿块”就诊于淮南市第一人民医院并通过常规超声证实为BI-RADS 3~4类肿块的104例患者的资料,患者均行彩色多普勒超声与超声弹性成像检查,根据病理结果分为良性组41例和恶性组63例,比较两组超声血流分级情况、超声血流参数值[搏动指数(pulsatility index,PI)、收缩期峰值血流速度(peak systolic velocity,PSV)、阻力指数(resistance index,RI)]、UE相关参数(长径、长径变化率、面积、面积比值)、通过受试者特征曲线(receiver operating characteristic curve,ROC)评估超声血流参数值联合UE相关参数值鉴别诊断BIRADS 3~4类乳腺良恶性肿块的价值。结果恶性组患者超声血流0级、Ⅰ级比率低于良性组,差异有统计学意义(P<0.05),Ⅱ级、Ⅲ级比率高于良性组,差异有统计学意义(P<0.05)。恶性组患者PI、RI、PSV高于良性组,差异有统计学意义(P<0.05)。恶性组患者长径、长径变化率和面积、面积比值均高于良性组,差异有统计学意义(P<0.05)。绘制ROC曲线发现,当超声血流参数值联合UE相关参数值时,其鉴别诊断BI-RADS3~4类乳腺良恶性肿块的AUC为0.920(95%CI:0.864~0.957,P<0.001),灵敏度为84.38%,特异度为87.50%。结论血流相关参数联合超声弹性成像鉴别诊断BI-RADS3~4类乳腺良恶性肿块的价值较高,两项技术联合应用更具优越性。

乳腺超声检查在乳腺肿瘤临床诊断中的应用价值研讨

目的评析乳腺肿瘤临床诊断中采用乳腺超声检查的有效性。方法选取在2020年2月—2023年2月期间无锡市太湖医院接诊的60例疑似乳腺肿瘤患者作为研究对象,均提供乳腺超声检查,以手术病理诊断作为金标准,分析乳腺超声检查应用在乳腺肿瘤中的应用效果。结果手术病理诊断检出恶性率34.67%、良性率68.33%;乳腺超声检查恶性率30.00%、良性率70.00%。乳腺超声检查的敏感度为84.21%、特异度为95.12%、准确性91.67%、阳性预测值88.89%、阴性预测值为92.86%。恶性肿瘤患者的血管阻力指数(0.72±0.15)、收缩期峰值的最大血流速度(21.56±6.28)cm/s均高于良性患者,差异有统计学意义(t=6.2960、8.1617,P<0.05)。结论乳腺肿瘤临床诊断中采用乳腺超声检查具有较高的准确率,应用效能高,在肿瘤良恶性鉴别中具有突出效果,值得在临床中使用和推广。

彩色多普勒超声鉴别诊断乳腺癌及乳腺增生结节的价值

目的 分析乳腺癌及乳腺增生结节用彩色多普勒超声(CDUs)鉴别诊断效果与价值。方法 我院于2019年11月至2022年11月就诊的乳腺肿块患者80例为研究对象,均采取CDUs检查。依据病理检查结果分为乳腺增生结节组(38例)和乳腺癌组(42例)。观察CDUs影像特征、血流丰富程度、动脉血流参数等指标。结果 两组小分叶状改变、皮肤增厚、病灶内部结构紊乱、腋窝淋巴结肿大、乳头凹陷特征比较无差异(P> 0.05);乳腺癌组边缘模糊伴毛刺、血流信号异常、点状微小钙化、肿块影、回声不均匀、病灶形态不规则特征更明显(P <0.05)。两组血流丰富程度、动脉血流参数对比有差异(P <0.05)。CDUs诊断乳腺癌及乳腺增生结节敏感度95.24%、特异度97.37%、准确度96.25%。结论 CDUs能精准鉴别乳腺癌、乳腺增生结节疾病,有效提高诊断敏感度、特异度、准确度,减少误诊、漏诊现象。

彩色多普勒超声在鉴别诊断良恶性乳腺结节中的临床价值

目的:分析彩色多普勒超声在良恶性乳腺结节中的鉴别诊断效能。方法:选取2021年4月—2022年4月高唐县人民医院收治的97例乳腺结节患者,所有患者均行彩色多普勒超声检查,以病理检查结果为“金标准”,统计分析彩色多普勒超声在乳腺结节良恶性中的诊断效果。结果:97例乳腺结节患者中,病理检查42例恶性,55例良性,彩色多普勒超声共检出40例恶性,良性57例。以病理检查为“金标准”,彩色多普勒超声检查的灵敏度为92.86%(39/42)、特异度为98.18%(54/55)、准确度为95.88%(39+54)/97、阳性预测值为97.50%(39/40)、阴性预测值为94.74%(54/57),Kappa=0.916,一致性极好;良性结节的形态不规则、边界不清晰、血流丰富、有钙化占比低于恶性乳腺结节,差异有统计学意义(P<0.05);良性乳腺结节的搏动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、收缩期峰值流速(peak systolic velocity,PSV)低于恶性乳腺结节,差异有统计学意义(P<0.05)。结论:彩色多普勒超声在良恶性乳腺结节鉴别诊断中效果显著,且不同性质的乳腺结节其影像特征与血流参数存在较大差异。

超声弹性成像定量参数对乳腺实性肿块的鉴别诊断分析

目的超声弹性成像的广泛应用提高了乳腺肿瘤的检出率，对乳腺肿块的鉴别诊断具有重要优势。文中旨在探讨并比较超声弹性定量参数面积比（arearatio，AR）、整体应变率比值（entirestrainratio，ESR）、局部应变率比值（10colizedstrainratio，LSR）、整体脂肪病灶比值（entirefattolesionratio，EFLR）、局部脂肪病灶比值（10colizedfattolesionratio，LFLR）对乳腺良恶性病变的鉴别诊断价值。方法选取2015年1月至2016年1月在南京军区南京总医院行乳腺检查的患者110例共113个病灶，含良性病灶59个、恶性病灶54个，进行超声弹性成像定量参数测量，以病理结果作为金标准，比较良恶性病灶超声弹性成像的AR、ESR、LSR、EFLR、LFLR，并绘制ROC曲线，联合常规超声和超声弹性成像参数鉴别诊断乳腺良恶性病变，计算各个参数对良恶性病灶诊断的准确性、敏感性、特异性、阳性似然比和阴性似然比，确定准确性最高的定量参数。结果恶性病灶超声弹性成像的AR、ESR、LSR、EFLR、LFLR平均值均高于良性病灶（P=0．000）。超声弹性成像的AR、ESR、LSR、EFLR、LFLR鉴别诊断肿瘤良恶性的AUC均高于常规超声；AR与ESR的AUC均高于常规超声、LSR、EFLR、LFLR（P〈0．000）。常规超声分别联合超声弹性成像的AR、ESR、EFLR、LFLR鉴别良恶性病灶的阳性似然比值（11．581、8．272、3．482、2．458、2．100）均高于单纯常规超声（1．523），准确性、敏感性、特异性亦高于单纯常规超声（P〈0．000）。常规超声分别联合超声弹性成像的AR、ESR鉴别诊断良恶性病灶的AUC[0．940（0．890—0．990）、0．941（0．891～0．990）]高于单纯常规超声及常规超声分别联合超声弹性成像的LSR、EFLR、LFLR[0．669（0．669—0．768）、0．837（0．758～0．915）、0．763（0．673～0．852）、0．787（0．701—0．874）]；其准确性、敏感性、特异性、阳性似然比均高于单纯常规超声及常规超声分别联合超声弹性成像的LRS、EFLR、LFLR（P〈0．000）。结论超声弹性成像定量分析有助于乳腺病变良恶性的鉴别，其中常规超声分别联合超声弹性成像的AR、ESR诊断准确性优于常规超声分别联合超声弹性成像的LSR、EFLR和LFLR，可为常规超声鉴别乳腺良恶性病变提供更为客观可靠的依据。