The Value of Color Doppler Ultrasound,Ultrasound Elastography and Contrast-Enhanced Ultrasound in the Diagnosis of Breast Cancer and Evaluation of the Efficacy of Neoadjuvant Chemotherapy
Objective To investigate the value of color Doppler ultrasound(CDUS),ultrasound elastography(UE)and contrast-enhanced ultrasound(CEUS)in the diagnosis of breast canc-er and the evaluation of the efficacy of neoadjuvant chemotherapy.Methods A total of 106 sus-pected breast cancer patients diagnosed and treated in Zhengzhou Third People's Hospital from May 2020 to March 2022 were selected as the study objects.A total of 57 cases of breast canc-er and 49 cases of benign lesions were diagnosed by pathological examination.The positive and negative predictive values were calculated by the four-table method,and the ROC curve model was used to analyze the AUC value,sensitivity and specificity of CDUS,UE,and CEUS in the combined diagnosis of breast cancer.The pathologically diagnosed breast cancer patients were treated with neoadjuvant chemotherapy,the overall response rate was observed,and the ROC curve model was used to analyze the CDUS combined parameters,UE score,CEUS combined parameters,and the AUC value,sensitivity and specificity of the three combined predicting effi-cacy.Results After CDUS examination,the positive and negative predictive values of 106 suspec-ted breast cancer patients were 60.71%and 54.00%,respectively,which showed poor consis-tency compared with the gold standard(Kappa=0.147,P>0.05).After UE examination,the posi-tive and negative predictive values were 71.43%and 66.00%,respectively,with general consis-tency compared with the gold standard(Kappa=0.375,P<0.05).After CEUS examination,the positive and negative predictive values were 80.36%and 76.00%,respectively,with general con-sistency compared with the gold standard(Kappa = 0.564,P<0.001).Irregular shape,unclear boundary,grade Ⅱ and Ⅲ blood flow signal,calcification,attenuation of rear echo,aspect ratio≥1 accounted for a higher proportion than good(P<0.05).The proportion of benign UE score 1 and 2 was higher than that of malignant UE score,while the proportion of 4 and 5 was lower than that of malignant UE score(P<0.05).The proportion of non-uniform enhancement,border-less enhancement and irregular enhancement in malignant was higher than that in benign(P<0.05).All 57 breast cancer patients diagnosed by pathology were treated with neoadjuvant chemotherapy,and the total remission rate was 71.93%.After chemotherapy,RI,AT and TTP were higher than before chemotherapy,while PSV,PI and UE scores were lower than before chemotherapy(P<0.05).ROC curve analysis showed that the AUC values of CDUS,UE,CEUS and combined diagnosis of breast cancer were(0.574,0.688,0.782,0.905,P<0.05),respectively.The AUC values of CDUS combination parameter,UE score,CEUS combination parameter,and three combination predicted curative effect were(0.779,0.798,0.778,0.896,P<0.05).Conclusion The efficacy of CDUS,UE and CEUS combined in diagnosing breast cancer and evaluating the efficacy of neoadjuvant chemotherapy is higher than that of CDUS,UE and CEUS alone.
color doppler ultrasoundultrasound elastographycontrast-enhanced ultrasoundbreast cancerneoadjuvant chemotherapy
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