| 叶磊,杨杨,袁韵,张菁,余磊,胡娜娜,陶堃.显微超声造影(SR CEUS)鉴别诊断乳腺良、恶性结节[J].中国医学影像技术,2026,42(6):859~862 |
| 显微超声造影(SR CEUS)鉴别诊断乳腺良、恶性结节 |
| Super resolution contrast-enhanced ultrasound (SR CEUS) for differential diagnosis of benign and malignant breast nodules |
| 投稿时间：2025-12-02 修订日期：2026-05-11 |
| DOI：10.13929/j.issn.1003-3289.2026.06.010 |
| 中文关键词: 乳腺肿瘤 诊断,鉴别 超声检查 显微超声造影 |
| 英文关键词:breast neoplasms diagnosis, differential ultrasonography super resolution contrast-enhanced ultrasound |
| 基金项目:统筹推进世界一流大学和一流学科建设专项资金资助(YD9115202655)。 |
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| 中文摘要: |
| 目的 观察显微超声造影(SR CEUS)鉴别诊断乳腺良、恶性结节的价值。方法 回顾性纳入83例单发乳腺结节患者,根据病理结果分为恶性组(n=51)与良性组(n=32);比较组间常规超声所见、乳腺影像报告和数据系统(BI-RADS)风险分层(≤4A类或＞4A类)结果及SR CEUS微血管结构及血流动力学等参数,以多因素logistic回归分析获取乳腺良、恶性结节的独立鉴别因素并构建联合模型。绘制受试者工作特征曲线,计算曲线下面积(AUC),评估各单一因素及联合模型的鉴别诊断效能并以DeLong检验进行比较。结果 组间患者年龄,结节最大径、BI-RADS＞4A类占比、血管密度(VD)、血流容积(FWVD)、分形维数(FD)、灌注指数(PI)、平均强度(Mean Inten)、中值强度(Med Inten)、最大速度(Max Vel)及平均速度(Mean Vel)差异均有统计学意义(P均＜0.05)。多因素logistic回归分析发现,FWVD、FD、PI、Mean Vel及BI-RADS风险分层均为乳腺良、恶性结节的独立鉴别因素(P均＜0.05),其AUC分别为0.812、0.835、0.796、0.773及0.876;而以之构建的联合模型的AUC为0.969,高于上述各单一因素(P均＜0.05)。结论 SR CEUS有助于提高鉴别诊断乳腺良、恶性结节效能。 |
| 英文摘要: |
| Objective To explore the value of super resolution contrast-enhanced ultrasound (SR CEUS) for differential diagnosis of benign and malignant breast nodules. Methods A total of 83 patients with single breast nodule were retrospectively collected and divided into malignant group (n=51) and benign group (n=32) based on pathological results. Conventional ultrasound findings, Breast imaging reporting and data system (BI-RADS) risk stratification (≤4A or ＞4A), and SR CEUS microvascular structure and hemodynamic parameters of the lesions were compared between groups. Multivariable logistic regression analysis was performed to identify independent factors for differentiating malignant from benign breast nodules, and a combined model was constructed. The receiver operating characteristic curve was drawn, and the area under the curve (AUC) was calculated to evaluate the diagnostic performance of each the above factors alone and the combined model, which were then compared using DeLong test. Results Significant differences of patients’ age, the maximum diameter of nodule, the proportion of BI-RADS ＞4A, vascular density (VD), flow-weighted vascular density (FWVD), fractal dimension (FD), perfusion index (PI), the mean intensity (Mean Inten), the median intensity (Med Inten), the maximum velocity (Max Vel) and the mean velocity (Mean Vel) were found between groups (all P＜0.05). Multivariable logistic regression analysis identified FWVD, FD, PI, Mean Vel and BI-RADS risk stratification as the independent differential diagnostic factors of benign and malignant breast nodules (all P＜0.05), with AUC of 0.812, 0.835, 0.796, 0.773 and 0.876, respectively. AUC of the combined model was 0.969, higher than that of each single factor (all P＜0.05). Conclusion SR CEUS was helpful in improving differential efficiency of benign and malignant breast nodules. |
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