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The role of contrast-enhanced ultrasound in the diagnosis of malignant non-mass breast lesions and exploration of diagnostic criteria

医学 超声造影 放射科 超声波 接收机工作特性 诊断准确性 逻辑回归 乳房成像 曲线下面积 乳腺癌 癌症 乳腺摄影术 内科学
作者
Fan Zhang,Lifang Jin,Gang Li,Jia Chen,Qiusheng Shi,Lianfang Du,Rong Wu
出处
期刊:British Journal of Radiology [Wiley]
卷期号:94 (1120): 20200880-20200880 被引量:11
标识
DOI:10.1259/bjr.20200880
摘要

To assess the value of contrast-enhanced ultrasound (CEUS) for diagnosing malignant non-mass breast lesions (NMLs) and to explore the CEUS diagnostic criteria.A total of 116 patients with 119 NMLs detected by conventional US were enrolled. Histopathological results were used as the reference standard. The enhancement characteristics of NMLs in CEUS were compared between malignant and benign NMLs. The CEUS diagnostic criteria for malignant NMLs were established using independent diagnostic indicators identified by binary logistic regression analysis. The diagnostic performance of Breast Imaging Reporting and Data System-US (BI-RADS-US), CEUS, and BI-RADS-US combined with CEUS was evaluated and compared.Histopathological results showed 63 and 56 benign and malignant NMLs. Enhancement degree (OR = 5.75, p = 0.003), enhancement area (OR = 4.25, p = 0.005), and radial or penetrating vessels (OR = 7.54, p = 0.003) were independent diagnostic indicators included to establish the CEUS diagnostic criteria. The sensitivity and specificity of BI-RADS-US, CEUS, and BI-RADS-US combined with CEUS were 100 and 30.2%, 80.4 and 74.6%, and 94.6 and 77.8%, respectively; the corresponding areas under the receiver operating characteristic curve (AUC) were 0.819, 0.775, and 0.885, respectively.CEUS has a high specificity in malignant NML diagnosis based on the diagnostic criteria including enhancement degree, enhancement area, and radial or penetrating vessels, but with lower sensitivity than BI-RADS-US. The combination of CEUS and BI-RADS-US is an effective diagnostic tool with both high sensitivity and specificity for the diagnosis of malignant NMLs.In this study, we assessed the diagnostic value of CEUS for malignant NMLs and constructed a feasible diagnostic criterion. We further revealed that the combination of CEUS and BI-RADS-US has a high diagnostic value for malignant NMLs.

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