实时超声造影对乳腺肿瘤BI-RADS分类的诊断价值分析
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摘要
目的分析实时超声造影对乳腺肿瘤乳腺影像报告与数据系统(BI-RADS)分类的诊断价值。方法以120例乳腺实性肿块患者为研究对象。在常规超声的基础上行造影检查。分析超声造影检查的良、恶性肿瘤的增强程度、增强范围变化、增强边缘、灌注方式、造影剂分布和肿瘤血管图像特征情况,比较常规超声和超声造影的BI-RADS分类情况,并以病理检查为金标准评价比较两种检查方法的诊断能力。结果超声造影检查对于良性和恶性肿瘤的增强程度、增强范围变化、增强边缘、灌注方式、造影剂分布和肿瘤血管情况差异均具有统计学意义(P<0.05);常规超声和超声造影检查的BI-RADS分类情况差异不具有统计学意义(P>0.05);超声造影检查的准确度和对恶性肿瘤的灵敏度高于常规超声(P<0.05),两种检查方法对恶性肿瘤的特异度差异无统计学意义(P>0.05),但超声造影检查对恶性肿瘤的特异度略高于常规超声检查。结论造影检查可在常规超声基础上提高对乳腺肿瘤BI-RADS分类准确性,提高了对良恶性肿瘤的鉴别诊断准确度、特异度和灵敏度,为临床进一步诊治提供依据,但仍需扩大样本量进一步从超声检查操作和图像分析能力的规范性方面展开研究。
Objective To analyze the diagnostic value of real-time contrast-enhanced ultrasonography in breast imaging reporting and data system( BI-RADS) classification of breast tumor. Methods A total of 120 patients with a solid mass breastour were studied. All patients received contrast-enhancedultrasonography on the basis of conventional ultrasonography. The enhancement degree,enhanced range change,enhanced edge,perfusion method,contrastdistribution agent and tumor vascular image characteristics of benign and malignant tumor were compared. BI-RADSclassification and diagnostic capacity of conventional ultrasonography and contrast-enhanced ultrasonography were analyzed and analyze. Results The differences in enhancement degree,enhanced range change,enhanced edge,perfusion method,contrastdistribution agent and tumor vascular image characteristics between benign and malignant tumor were statistically significant( P < 0. 05);The difference in BI-RADSclassification between benign and malignant tumor was not statistically significant( P > 0. 05);The accuracy and sensitivity for malignant tumor of contrastenhanced ultrasonography was higher than those of conventional ultrasonography( P < 0. 05); The difference in specificity of 2 methods was not statistically significant( P > 0. 05),but contrast-enhancedultrasonography was slightly higher than conventional ultrasonography. Conclusion Contrast examination based on conventional ultrasonography can improve the accuracy,specificity and sensitivity of BI-RADS classification for tumor. It provides a basis for further clinical diagnosis and treatment. However,we still need to expand the sample size to furtherly standard the ultrasonic inspection operation and image analysis capability.
Objective To analyze the diagnostic value of real-time contrast-enhanced ultrasonography in breast imaging reporting and data system( BI-RADS) classification of breast tumor. Methods A total of 120 patients with a solid mass breastour were studied. All patients received contrast-enhancedultrasonography on the basis of conventional ultrasonography. The enhancement degree,enhanced range change,enhanced edge,perfusion method,contrastdistribution agent and tumor vascular image characteristics of benign and malignant tumor were compared. BI-RADSclassification and diagnostic capacity of conventional ultrasonography and contrast-enhanced ultrasonography were analyzed and analyze. Results The differences in enhancement degree,enhanced range change,enhanced edge,perfusion method,contrastdistribution agent and tumor vascular image characteristics between benign and malignant tumor were statistically significant( P < 0. 05);The difference in BI-RADSclassification between benign and malignant tumor was not statistically significant( P > 0. 05);The accuracy and sensitivity for malignant tumor of contrastenhanced ultrasonography was higher than those of conventional ultrasonography( P < 0. 05); The difference in specificity of 2 methods was not statistically significant( P > 0. 05),but contrast-enhancedultrasonography was slightly higher than conventional ultrasonography. Conclusion Contrast examination based on conventional ultrasonography can improve the accuracy,specificity and sensitivity of BI-RADS classification for tumor. It provides a basis for further clinical diagnosis and treatment. However,we still need to expand the sample size to furtherly standard the ultrasonic inspection operation and image analysis capability.
引文
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[6]陈玉宏.超声微泡在心血管疾病诊断中的应用[J].中西医结合心血管病杂志(电子版),2015,3(28):93-94.
[7]杜菲,侯素平,牟荣骥,等.经皮超声造影联合BIRADS分级对乳腺癌前哨淋巴结转移的诊断价值分析[J].中国妇幼保健,2016,31(2):427-429.
[8]刘健,高云华,苟凌云,等.实时超声造影对提高乳腺肿瘤BI-RADS分类准确性的价值[J].中国医学影像学杂志,2016,24(4):281-284.
[9]丛阳,陈曼,唐蕾,等.Kappa值评价乳腺肿瘤超声造影形态学指标的一致性[J].中国超声医学杂志,2014,30(8):676-679.
[10]刘博文,王青平,殷丽,等.桥本甲状腺炎不同时期的彩色多普勒超声表现分析[J].中国医药指南,2014,31(33):121-122.
[2]陈成华.乳腺癌影像学诊断进展综述[J].临床合理用药杂志,2013,6(10):171-172.
[3]D'orsi CJ,Sickles EA,Mendelson EB,et al.ACR BI-RADS breast imaging and reporting data system[J].Reston,VA:American College of Radiology,2013,206(3):666-672.
[4]罗佳,郑艳玲,谢晓燕,等.超声造影在乳腺影像报告与数据系统分类中应用的价值[J].中华医学超声杂志(电子版)2015,12(9):728-733.
[5]陈宇潇,倪成铭,张金梦,等.乳腺癌血管生成拟态的分子机制研究进展[J].中华乳腺病杂志:电子版,2017,11(2):97-101.
[6]陈玉宏.超声微泡在心血管疾病诊断中的应用[J].中西医结合心血管病杂志(电子版),2015,3(28):93-94.
[7]杜菲,侯素平,牟荣骥,等.经皮超声造影联合BIRADS分级对乳腺癌前哨淋巴结转移的诊断价值分析[J].中国妇幼保健,2016,31(2):427-429.
[8]刘健,高云华,苟凌云,等.实时超声造影对提高乳腺肿瘤BI-RADS分类准确性的价值[J].中国医学影像学杂志,2016,24(4):281-284.
[9]丛阳,陈曼,唐蕾,等.Kappa值评价乳腺肿瘤超声造影形态学指标的一致性[J].中国超声医学杂志,2014,30(8):676-679.
[10]刘博文,王青平,殷丽,等.桥本甲状腺炎不同时期的彩色多普勒超声表现分析[J].中国医药指南,2014,31(33):121-122.