首页|超声联合超声造影对乳腺病变的诊断效能及影响因素

超声联合超声造影对乳腺病变的诊断效能及影响因素

Diagnostic Efficacy and Influencing Factors of Ultrasonography Combined with Contrast-Enhanced Ultrasound in Breast Lesions

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目的 探究超声联合超声造影(CEUS)对乳腺病变的诊断效能,分析诊断准确度的影响因素.资料与方法 回顾性收集 2022 年 1 月—2023 年 2 月在解放军总医院第一医学中心行乳腺超声、CEUS检查并有明确病理结果的 784 例患者的临床资料和超声图像.分析超声、CEUS对乳腺病变良恶性的诊断效能,使用Logistic回归分析诊断错误的独立危险因素.结果 超声联合CEUS对乳腺病变良恶性诊断的敏感度、特异度和准确度分别为 89.2%、84.4%和 88.7%,曲线下面积为 0.932.多因素分析结果显示:病变表现为非肿块型(OR=1.927,P=0.047)、囊实混合性(OR=3.729,P=0.000)、超声造影高增强(OR=1.937,P=0.023)时诊断错误率高,>1.0 cm病变(OR=0.688,P=0.004)及常规超声探及可疑淋巴结的病变(OR=0.143,P=0.011)时诊断错误率低.结论 乳腺病变表现为非肿块型,囊实混合性及CEUS高增强时超声联合CEUS诊断错误率较高,需要进一步探索不同病变的增强模式.
Purpose To explore the diagnostic efficiency of ultrasound(US)combined with contrast-enhanced ultrasound(CEUS)in breast lesions and to analyze the related factors affecting the diagnostic accuracy.Materials and Methods From January 2022 to February 2023,the clinical data and ultrasound images of 784 patients who underwent breast US and CEUS examination with definite pathological results were retrospectively collected in the First Medical Center of the PLA General Hospital.The diagnostic efficacy of US combined with CEUS in benign and malignant breast lesions was analyzed,respectively.The independent risk factors for diagnostic errors were analyzed via Logistic regression.Results The sensitivity,specificity and accuracy of US combined with CEUS in the diagnosis of benign and malignant breast lesions were 89.2%,84.4%and 88.7%,respectively.The area under the receiver operating characteristic curve was 0.932.The results of multivariate Logistic regression analysis showed that the diagnosis error rate increased when the lesions were non-mass type(odds ratio,OR=1.927,P=0.047),complex cystic and solid(OR=3.729,P=0.000),and high-enhanced CEUS(OR=1.937,P=0.023),while the diagnosis error rate decreased when the lesions were large(OR=0.688,P=0.004)and with US-detect suspicious lymph node(OR=0.143,P=0.011).Conclusion When the breast lesions are non-mass type,complex cystic and solid lesions and hyper-enhancement,the diagnosis error rate of US combined with CEUS increased.It is necessary to further explore the enhancement patterns of different lesions.

Breast diseasesUltrasonographyContrast enhanced ultrasoundDiagnosis,differentialFactor analysis,statistical

付乃芹、李俊康、姜莹、李诗雨、牛瑞兰、王知力

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解放军总医院第一医学中心超声诊断科,北京 100853

乳腺疾病 超声检查 超声造影 诊断,鉴别 因素分析,统计学

国家自然科学基金军队保健课题装备综合研究项目

8207192522BJZ23LB20211A010011

2024

中国医学影像学杂志
中国医学影像技术研究会

中国医学影像学杂志

CSTPCD北大核心
影响因子:1.37
ISSN:1005-5185
年,卷(期):2024.32(1)
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