中国医学装备2024，Vol.21Issue(5) ：74-78.DOI:10.3969/j.issn.1672-8270.2024.05.014

Sonazoid超声造影在BI-RADS 4类乳腺结节诊疗中的应用价值研究

Study on the application value of Sonazoid contrast enhanced ultrasound in the diagnosis and treatment of BI-RADS 4 category of breast nodules

王瑞琦 马晓娟 段鹤立
中国医学装备2024，Vol.21Issue(5) ：74-78.DOI:10.3969/j.issn.1672-8270.2024.05.014
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Sonazoid超声造影在BI-RADS 4类乳腺结节诊疗中的应用价值研究

Study on the application value of Sonazoid contrast enhanced ultrasound in the diagnosis and treatment of BI-RADS 4 category of breast nodules

王瑞琦 1马晓娟 2段鹤立3
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作者信息

  • 1. 川北医学院医学影像学院 南充 637000;成都市第一人民医院超声科 成都 610000
  • 2. 成都市第一人民医院超声科 成都 610000
  • 3. 川北医学院医学影像学院 南充 637000
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摘要

目的:探讨Sonazoid超声造影定性与定量分析在诊断乳腺影像报告和数据系统(BI-RADS)4类乳腺病变中的临床应用价值.方法:收集2022年4月至2023年4月于成都市第一人民医院行穿刺活检或手术的乳腺病变患者53例(53个病灶均为BI-RADS 4类).根据乳腺结节病理结果将患者分为良性组(34例)和恶性组(19例).所有患者在穿刺活检或者手术前均已行Sonazoid超声造影(CEUS)检查,比较良性组和恶性组乳腺结节造影定性与定量指标之间的差异,选取具有统计学差异的指标纳入回归方程,分别绘制受试者工作特征(ROC)曲线,获得ROC曲线下面积(AUC).使用Sonoliver软件将造影时乳腺结节与周围正常组织的增强强度差异编码成直观的彩色图像,生成动态血管模型(DVP)参数图,分析在乳腺良、恶性结节中图像颜色的差异.结果:乳腺结节的Sonazoid超声造影定性指标观察中,恶性组乳腺结节多表现为增强范围扩大[13例(占68.4%)],不均匀增强[14例(占73.7%)],周围有穿支血流[12例(占63.2%)],与良性组比较差异均有统计学意义(x2=10.268、9.642、5.717,P＜0.05);乳腺结节的Sonazoid超声造影定量指标观察中,恶性组乳腺结节造影的上升时间(RT)、平均渡越时间(mTT)时长小于良性组,差异有统计学意义(Z=-1.985、-2.272,P＜0.05).将上述指标纳入多因素分析,分别建立定性、定量指标预测恶性结节的回归方程,定性、定量分析的ROC曲线下面积分别为0.723、0.902,定性分析结果优于定量分析,差异有统计学意义(Z=-1.965,P＜0.05).在DVP参数图像中,良性组34例结节中有23例(占67.6%)结节表现为病灶,感兴趣区域(ROI)内大部分呈较单调的红、黄色填充;恶性组19例中有15例(占78.9%)结节的ROI内呈紊乱不规则分散或团块状的斑片状红黄色填充.结论:Sonazoid超声造影能够鉴别乳腺BI-RADS 4类结节的良恶性,定性指标的诊断效能优于定量指标.

Abstract

Objective:To investigate the clinical application value of qualitative and quantitative analysis of Sonazoid contrast-enhanced ultrasound(CEUS)in the 4 category of breast lesions of the Breast Imaging Reporting and Data System(BI-RADS)of diagnosis.Methods:A total of 53 patients with breast lesions(All 53 lesions were BI-RADS 4 category)who underwent biopsy or surgery in Chengdu First People's Hospital from April 2022 to April 2023 were selected.According to the pathological results of breast nodules,they were respectively divided into benign and malignant groups.All patients had underwent Sonazoid CEUS before biopsy or surgery.The differences of the qualitative and quantitative indexes of the breast nodules CEUS between benign and malignant groups were compared.The indexes with statistical significances were fitted into regression equation.And then,the receiver operating characteristic(ROC)curves were drawn for obtaining area under curve(AUC).The differences of enhanced strengths of breast nodules and surrounding normal tissues in CEUS were coded to intuitive color images,and generated dynamic vascular model(DVP)parameter picture by using Sonoliver software.The differences of image colors between benign and malignant breast nodules were analyzed.Results:According to the results of biopsy or surgical pathology,the 53 breast nodules were respectively divided into benign group(34 cases)and malignant group(19 cases).In qualitative indexes of Sonazoid-CEUS for breast nodules,the most appearance of the malignant nodules showed 13 cases were the enlargement of enhancement range(68.4%),and 14 cases were uneven enhancement(73.7%)and 12 cases were peripheral perforating blood flow(63.2%),and the differences of them between benign and malignant group were statistically significant(x2=10.268,9.642,5.717,P＜0.05),respectively.In the quantitative index of Sonazoid-CEUS for breast nodules,the rise time(RT)and mean transition time(mTT)of breast nodules of malignant group were significantly shorter than those of benign group,and the differences were statistically significant(Z=-1.985,-2.272,P＜0.05).After the above indexes were fitted into multiple factors analysis,the regression equations of predicting malignant nodules by using qualitative and quantitative indexes were respectively established.The AUC values of ROC curves of qualitative and quantitative analyses were respectively 0.723 and 0.902.The result of qualitative analysis was significantly better than that of quantitative analysis(Z=-1.965,P＜0.05).In DVP parametric images,the nodules of 23 cases(67.6%)of 32 nodules of benign group appeared lesions,and the most in region of interesting(ROI)appeared monotonous red/yellow filling,and 15 cases(78.9%)of 19 cases of malignant group appeared lesions,and the ROI inside appeared patchy red/yellow filling of disordered,irregular,scattered or clumpy shape.Conclusion:Sonazoid CEUS can discriminate benign and malignant nodules of breast BI-RADS 4 category,and the diagnostic efficacy of qualitative indexes is better than that of quantitative indexes..

关键词

乳腺病变/示卓安(Sonazoid)造影剂/超声造影(CEUS)/乳腺影像报告和数据系统(BI-RADS)4类

Key words

Breast lesion/Sonazoid contrast agent/Contrast-enhanced ultrasound(CEUS)/Breast Imaging Reporting and Data System(BI-RADS)4 category

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基金项目

四川省卫生计生委科研项目(20PJ121)

出版年

2024
中国医学装备
中国医学装备协会

中国医学装备

CSTPCD
影响因子：0.882
ISSN：1672-8270
参考文献量14
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