| 徐平,杨敏,刘勇,张红,吴兰英.超声造影定性及定量分析鉴别乳腺良恶性非肿块型病变[J].中国医学影像技术,2020,36(12):1825~1829 |
| 超声造影定性及定量分析鉴别乳腺良恶性非肿块型病变 |
| Qualitative and quantitative analysis of contrast-enhanced ultrasound for differential diagnostic of benign and malignant breast non-mass lesions |
| 投稿时间：2020-02-28 修订日期：2020-10-26 |
| DOI：10.13929/j.issn.1003-3289.2020.12.014 |
| 中文关键词: 乳腺肿瘤 超声检查 造影剂 定性研究 定量研究 |
| 英文关键词:breast neoplasms ultrasonography contrast media qualitative research quantitative research |
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| 中文摘要: |
| 目的 观察超声造影（CEUS）定性及定量分析鉴别乳腺良恶性非肿块型病变（NML）的价值。方法 回顾性分析57例乳腺NML患者（57个病灶），根据病理结果分为良性与恶性病变组，对比组间CEUS定性及定量指标差异，选择差异有统计学意义的参数建立回归方程，采用ROC曲线评估3个方程对恶性病变的诊断效能。结果 57个乳腺NML中，经病理确诊良性病变31例（良性组），恶性病变26例（恶性组），2组NMLs增强强度、病变范围、周边血管和峰值强度（PI）、曲线下面积（AUC）及平均渡越时间（MTT）差异均有统计学意义（P均<0.05）；多因素分析结果显示，定性参数中的增强强度、病变范围，定量参数中的PI、AUC以及二者联合分析所示病变范围和PI均为鉴别诊断乳腺良恶性NMLs的独立因子（P均<0.05）。据此分别建立定性、定量及二者联合分析的回归方程预测恶性病变的AUC分别为0.80、0.63和0.71，定性分析优于定量分析（Z=－3.02，P<0.01），而与二者联合分析差异无统计学意义（Z=－0.10，P=0.54）。结论 CEUS定性和定量分析均对鉴别乳腺良恶性NMLs有一定价值，定性参数的诊断效能优于定量参数。 |
| 英文摘要: |
| Objective To explore the value of qualitative and quantitative analysis of contrast-enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant breast non-mass lesions (NML). Methods Data of 57 patients with breast NML were retrospectively analyzed. According to the pathological results, the patients were divided into benign or malignant groups, and CEUS qualitative and quantitative indexes of benign and malignant breast NML were compared between groups. Parameters statistically different between groups were selected to establish the regression equations. ROC curve was used to evaluate the diagnostic efficacy of qualitative analysis, quantitative analysis and the combination of them for malignant lesions. Results Among 57 lesions, 31 were pathologically confirmed benign (benign group)and 26 were malignant (malignant group). Statistically significant differences of intensity enhancement, lesion range, peripheral vessels, peak intensity (PI), area under the curve (AUC) and mean transit time (MTT) were found between groups (all P<0.05). Further multi-factor analysis results showed that enhanced intensity and lesion range of qualitative analysis, PI and AUC of quantitative analysis as well as lesion range and PI of combination analysis were all independent factors for differential diagnosis of benign and malignant breast NML (all P<0.05). Then the above independent factors were used to establish the regression equations of qualitative, quantitative and combined analysis. The AUC of 3 equations for prediction of malignant lesions was 0.80, 0.63 and 0.71, respectively. The qualitative analysis was superior to quantitative analysis (Z=－3.02, P<0.01), which was not statistically different with combination analysis (Z=－0.10, P=0.54). Conclusion Both qualitative and quantitative analysis of CEUS had certain application value for differentiating benign from malignant breast NML, whereas the diagnostic efficacy of qualitative analysis was superior to that of quantitative analysis. |
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