Objective:To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system(BI-RADS)category 3 and above.Methods:From June 2021 to July 2022,163 patients with breast ...Objective:To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system(BI-RADS)category 3 and above.Methods:From June 2021 to July 2022,163 patients with breast nodules of BI-RADS 3 or above were selected as the research subjects.After pathological diagnosis,24 cases were malignant breast nodules of BI-RADS 3 or above,while 139 cases were benign breast nodules of BI-RADS 3 or above.The diagnosis rate of malignant and benign breast nodules of BI-RADS 3 or above,including 95%CI,was observed and analyzed.Results:The malignant and benign detection rates of conventional ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of ultrasound imaging were 93.18%and 87.50%,respectively,with 95%CIs greater than 0.7.Conclusion:Ultrasound imaging can help improve the diagnostic accuracy of benign and malignant breast nodules of BI-RADS 3 and above and reduce the misdiagnosis rate.展开更多
AIM: To determine whether contrast-enhanced ultrasound(CEUS) can improve the precision of breast imaging reporting and data system(BI-RADS) categorization. METHODS: A total of 230 patients with 235 solid breast lesion...AIM: To determine whether contrast-enhanced ultrasound(CEUS) can improve the precision of breast imaging reporting and data system(BI-RADS) categorization. METHODS: A total of 230 patients with 235 solid breast lesions classified as BI-RADS 4 on conventional ultrasound were evaluated. CEUS was performed within one week before core needle biopsy or surgical resection and a revised BI-RADS classification was assigned based on 10 CEUS imaging characteristics. Receiver operating characteristic curve analysis was then conducted to evaluate the diagnostic performance of CEUS-based BI-RADS assignment with pathological examination as reference criteria. RESULTS: The CEUS-based BI-RADS evaluation classified 116/235(49.36%) lesions into category 3, 20(8.51%), 13(5.53%) and 12(5.11%) lesions into categories 4A, 4B and 4C, respectively, and 74(31.49%) into category 5. Selecting CEUS-based BI-RADS category 4A as an appropriate cut-off gave sensitivity and specificity values of 85.4% and 87.8%, respectively, for the diagnosisof malignant disease. The cancer-to-biopsy yield was 73.11% with CEUS-based BI-RADS 4A selected as the biopsy threshold compared with 40.85% otherwise, while the biopsy rate was only 42.13% compared with 100% otherwise. Overall, only 4.68% of invasive cancers were misdiagnosed.CONCLUSION: This pilot study suggests that evaluation of BI-RADS 4 breast lesions with CEUS results in reduced biopsy rates and increased cancer-to-biopsy yields.展开更多
AIM: To build and evaluate predictive models for contrast-enhanced ultrasound(CEUS) of the breast to distinguish between benign and malignant lesions. METHODS: A total of 235 breast imaging reporting and data system(B...AIM: To build and evaluate predictive models for contrast-enhanced ultrasound(CEUS) of the breast to distinguish between benign and malignant lesions. METHODS: A total of 235 breast imaging reporting and data system(BI-RADS) 4 solid breast lesions were imaged via CEUS before core needle biopsy or surgical resection. CEUS results were analyzed on 10 enhancing patterns to evaluate diagnostic performance of three benign and three malignant CEUS models, with pathological results used as the gold standard. A logistic regression model was developed basing on the CEUS results, and then evaluated with receiver operating curve(ROC). RESULTS: Except in cases of enhanced homogeneity, the rest of the 9 enhancement appearances were statistically significant(P < 0.05). These 9 enhancement patterns were selected in the final step of the logistic regression analysis, with diagnostic sensitivity and specificity of 84.4% and 82.7%, respectively, and the area under the ROC curve of 0.911. Diagnostic sensitivity, specificity, and accuracy of the malignant vs benign CEUS models were 84.38%, 87.77%, 86.38% and 86.46%, 81.29% and 83.40%, respectively. CONCLUSION: The breast CEUS models can predict risk of malignant breast lesions more accurately, decrease false-positive biopsy, and provide accurate BIRADS classification.展开更多
目的研究年龄联合剪切波弹性成像(SWE)对乳腺影像报告数据系统(BI-RADS)4a类乳腺肿物的诊断价值。方法对82例罹患乳腺肿物的患者共87个分类为BI-RADS 4a类的肿物进行超声SWE检查,测量肿物内部最大杨氏模量值(Emax)以及肿物周边2 mm Emax...目的研究年龄联合剪切波弹性成像(SWE)对乳腺影像报告数据系统(BI-RADS)4a类乳腺肿物的诊断价值。方法对82例罹患乳腺肿物的患者共87个分类为BI-RADS 4a类的肿物进行超声SWE检查,测量肿物内部最大杨氏模量值(Emax)以及肿物周边2 mm Emax,并记录患者年龄。以病理结果为“金标准”绘制受试者工作特征(ROC)曲线,分别获取年龄、肿物内部Emax以及肿物周边2 mm Emax的最佳截断值,并在此基础上,分别绘制年龄联合肿物内部Emax与年龄联合肿物周边2 mm Emax的ROC曲线,以分析两项联合指标的诊断效能。结果87个BI-RADS 4a类肿物的病理诊断结果为良性57个、恶性30个。年龄、肿物内部Emax、肿物周边2 mm Emax均对乳腺肿物有一定的预测价值,其中年龄最佳截断值为50.5岁,肿物内部Emax最佳截断值为119.490 kPa,肿物周边2 mm Emax最佳截断值为133.550 kPa。年龄联合肿物内部Emax的曲线下面积(AUC)为0.756,标准误(SE)为0.055(P<0.001),诊断灵敏度为0.575,特异度为0.937,诊断指数最大为0.512;年龄联合肿物周边2 mm Emax的AUC为0.794,SE为0.051(P<0.001),诊断灵敏度为0.650,特异度为0.937,诊断指数最大为0.587。结论年龄联合肿物内部Emax与年龄联合肿物周边2 mm Emax均对BI-RADS 4a类乳腺肿物有一定的诊断价值,且能够减少良性肿物不必要的手术或穿刺活检。展开更多
目的:探讨超微血流成像(ultra-microangiography,UMA)对乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)4类乳腺结节的鉴别诊断价值。方法:回顾并收集2023年1月—2024年2月在山西医科大学第一医院行常规二...目的:探讨超微血流成像(ultra-microangiography,UMA)对乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)4类乳腺结节的鉴别诊断价值。方法:回顾并收集2023年1月—2024年2月在山西医科大学第一医院行常规二维超声、UMA检查的女性乳腺肿瘤患者。分析UMA血流像素比及血流特征在乳腺良恶性肿瘤之间的差异,对差异有统计学意义且阳性预测值高的指标赋分,根据赋分值制作受试者工作特征(receiver operating characteristic,ROC)曲线,并选择最佳截断值调整乳腺良恶性肿瘤BI-RADS分级,绘制调整前后ROC曲线,研究UMA对BI-RADS 4类乳腺结节的鉴别诊断价值。结果:共纳入101例乳腺肿瘤患者。cUMA、pUMA、sUMA血流像素比在良恶性肿瘤之间差异均无统计学意义(Z值分别为-0.194、-1.202、-1.117,P值分别为0.846、0.229、0.264)。UMA血流特征中,有无穿支血流(χ^(2)=8.394,P=0.004)、边缘血流走行是否扭曲(χ^(2)=7.317,P=0.007)、边缘血流分布(χ^(2)=55.733,P<0.001)、中央血流走行是否扭曲(χ^(2)=4.178,P=0.041)、中央是否有血流缺损(χ^(2)=6.051,P=0.014)在乳腺良恶性肿瘤之间差异有统计学意义。当肿瘤有穿支血流、边缘血流走行扭曲、边缘血流分布为周边穿入性血流、放射状血流、中央血流走行扭曲、中央有血流缺损时赋1分,曲线下面积(area under curve,AUC)为0.871,95%CI 0.799~0.943。赋分后,BI-RADS 4类乳腺肿瘤AUC由0.741提高到0.825。结论:UMA能够提高BI-RADS 4类乳腺肿瘤良恶性的诊断准确度,是诊断乳腺癌的有效血流检测手段。展开更多
目的:探讨利用超声造影(contrast-enhanced ultrasound,CEUS)评分法对乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BIRADS)4类再调整的临床应用价值。方法:回顾并分析2021年5月—2024年4月上海市杨浦区市东医院...目的:探讨利用超声造影(contrast-enhanced ultrasound,CEUS)评分法对乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BIRADS)4类再调整的临床应用价值。方法:回顾并分析2021年5月—2024年4月上海市杨浦区市东医院及上海市第四人民医院经术后病理学检查或穿刺活检确诊的乳腺结节患者资料。所有结节均经常规超声检查并提示为BI-RADS 4类,所有结节均进行CEUS检查并赋值评分,根据评分结果再调整BI-RADS分类,比较调整前后的诊断效能。另将乳腺结节按最大径分为3组,评估不同大小结节CEUS赋值评分后的诊断效能。结果:共纳入105例患者,共计109个结节,其中良性结节59个,恶性结节50个。BI-RADS 4b及以上考虑为恶性,结合CEUS评分法后诊断的灵敏度和准确度(94.00%和92.66%)明显高于常规超声(52.00%和75.23%,P<0.05),调整后受试者工作特征(receiver operating characteristic,ROC)曲线的曲线下面积为0.95,明显高于常规超声(0.76)。结合CEUS评分法后3组不同大小乳腺结节诊断的灵敏度均有显著提高(P<0.05),诊断的准确度均提高至90%以上,尤其是≥2 cm组结节诊断准确度提高最明显(65.38%vs 96.15%,P<0.05)。结论:CEUS评分法具有较高的诊断效能,有助于BIRADS 4类结节的再调整,具有广泛的临床应用价值。展开更多
乳腺癌的发病率逐年递增,且发病年龄趋于年轻化。乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS)4类病变的恶性概率跨度较大(2%~95%),因只能通过活检明确病理诊断,故造成一些不必要的活检。近年来,乳腺超...乳腺癌的发病率逐年递增,且发病年龄趋于年轻化。乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS)4类病变的恶性概率跨度较大(2%~95%),因只能通过活检明确病理诊断,故造成一些不必要的活检。近年来,乳腺超声领域涌现出许多新技术,包括弹性成像技术、超微血管血流成像技术、超声造影技术、自动乳腺全容积成像技术、“萤火虫”技术、S-Detect技术和超声影像组学技术等,其作为辅助手段为临床提供了更多的诊断信息,一定程度上提高了病变的检出率。本文旨在对乳腺超声新技术在BI-RADS 4类乳腺肿块良恶性鉴别诊断中的应用价值进行综述。展开更多
文摘Objective:To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system(BI-RADS)category 3 and above.Methods:From June 2021 to July 2022,163 patients with breast nodules of BI-RADS 3 or above were selected as the research subjects.After pathological diagnosis,24 cases were malignant breast nodules of BI-RADS 3 or above,while 139 cases were benign breast nodules of BI-RADS 3 or above.The diagnosis rate of malignant and benign breast nodules of BI-RADS 3 or above,including 95%CI,was observed and analyzed.Results:The malignant and benign detection rates of conventional ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of ultrasound imaging were 93.18%and 87.50%,respectively,with 95%CIs greater than 0.7.Conclusion:Ultrasound imaging can help improve the diagnostic accuracy of benign and malignant breast nodules of BI-RADS 3 and above and reduce the misdiagnosis rate.
文摘AIM: To determine whether contrast-enhanced ultrasound(CEUS) can improve the precision of breast imaging reporting and data system(BI-RADS) categorization. METHODS: A total of 230 patients with 235 solid breast lesions classified as BI-RADS 4 on conventional ultrasound were evaluated. CEUS was performed within one week before core needle biopsy or surgical resection and a revised BI-RADS classification was assigned based on 10 CEUS imaging characteristics. Receiver operating characteristic curve analysis was then conducted to evaluate the diagnostic performance of CEUS-based BI-RADS assignment with pathological examination as reference criteria. RESULTS: The CEUS-based BI-RADS evaluation classified 116/235(49.36%) lesions into category 3, 20(8.51%), 13(5.53%) and 12(5.11%) lesions into categories 4A, 4B and 4C, respectively, and 74(31.49%) into category 5. Selecting CEUS-based BI-RADS category 4A as an appropriate cut-off gave sensitivity and specificity values of 85.4% and 87.8%, respectively, for the diagnosisof malignant disease. The cancer-to-biopsy yield was 73.11% with CEUS-based BI-RADS 4A selected as the biopsy threshold compared with 40.85% otherwise, while the biopsy rate was only 42.13% compared with 100% otherwise. Overall, only 4.68% of invasive cancers were misdiagnosed.CONCLUSION: This pilot study suggests that evaluation of BI-RADS 4 breast lesions with CEUS results in reduced biopsy rates and increased cancer-to-biopsy yields.
文摘AIM: To build and evaluate predictive models for contrast-enhanced ultrasound(CEUS) of the breast to distinguish between benign and malignant lesions. METHODS: A total of 235 breast imaging reporting and data system(BI-RADS) 4 solid breast lesions were imaged via CEUS before core needle biopsy or surgical resection. CEUS results were analyzed on 10 enhancing patterns to evaluate diagnostic performance of three benign and three malignant CEUS models, with pathological results used as the gold standard. A logistic regression model was developed basing on the CEUS results, and then evaluated with receiver operating curve(ROC). RESULTS: Except in cases of enhanced homogeneity, the rest of the 9 enhancement appearances were statistically significant(P < 0.05). These 9 enhancement patterns were selected in the final step of the logistic regression analysis, with diagnostic sensitivity and specificity of 84.4% and 82.7%, respectively, and the area under the ROC curve of 0.911. Diagnostic sensitivity, specificity, and accuracy of the malignant vs benign CEUS models were 84.38%, 87.77%, 86.38% and 86.46%, 81.29% and 83.40%, respectively. CONCLUSION: The breast CEUS models can predict risk of malignant breast lesions more accurately, decrease false-positive biopsy, and provide accurate BIRADS classification.
文摘目的研究年龄联合剪切波弹性成像(SWE)对乳腺影像报告数据系统(BI-RADS)4a类乳腺肿物的诊断价值。方法对82例罹患乳腺肿物的患者共87个分类为BI-RADS 4a类的肿物进行超声SWE检查,测量肿物内部最大杨氏模量值(Emax)以及肿物周边2 mm Emax,并记录患者年龄。以病理结果为“金标准”绘制受试者工作特征(ROC)曲线,分别获取年龄、肿物内部Emax以及肿物周边2 mm Emax的最佳截断值,并在此基础上,分别绘制年龄联合肿物内部Emax与年龄联合肿物周边2 mm Emax的ROC曲线,以分析两项联合指标的诊断效能。结果87个BI-RADS 4a类肿物的病理诊断结果为良性57个、恶性30个。年龄、肿物内部Emax、肿物周边2 mm Emax均对乳腺肿物有一定的预测价值,其中年龄最佳截断值为50.5岁,肿物内部Emax最佳截断值为119.490 kPa,肿物周边2 mm Emax最佳截断值为133.550 kPa。年龄联合肿物内部Emax的曲线下面积(AUC)为0.756,标准误(SE)为0.055(P<0.001),诊断灵敏度为0.575,特异度为0.937,诊断指数最大为0.512;年龄联合肿物周边2 mm Emax的AUC为0.794,SE为0.051(P<0.001),诊断灵敏度为0.650,特异度为0.937,诊断指数最大为0.587。结论年龄联合肿物内部Emax与年龄联合肿物周边2 mm Emax均对BI-RADS 4a类乳腺肿物有一定的诊断价值,且能够减少良性肿物不必要的手术或穿刺活检。
文摘目的:探讨超微血流成像(ultra-microangiography,UMA)对乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)4类乳腺结节的鉴别诊断价值。方法:回顾并收集2023年1月—2024年2月在山西医科大学第一医院行常规二维超声、UMA检查的女性乳腺肿瘤患者。分析UMA血流像素比及血流特征在乳腺良恶性肿瘤之间的差异,对差异有统计学意义且阳性预测值高的指标赋分,根据赋分值制作受试者工作特征(receiver operating characteristic,ROC)曲线,并选择最佳截断值调整乳腺良恶性肿瘤BI-RADS分级,绘制调整前后ROC曲线,研究UMA对BI-RADS 4类乳腺结节的鉴别诊断价值。结果:共纳入101例乳腺肿瘤患者。cUMA、pUMA、sUMA血流像素比在良恶性肿瘤之间差异均无统计学意义(Z值分别为-0.194、-1.202、-1.117,P值分别为0.846、0.229、0.264)。UMA血流特征中,有无穿支血流(χ^(2)=8.394,P=0.004)、边缘血流走行是否扭曲(χ^(2)=7.317,P=0.007)、边缘血流分布(χ^(2)=55.733,P<0.001)、中央血流走行是否扭曲(χ^(2)=4.178,P=0.041)、中央是否有血流缺损(χ^(2)=6.051,P=0.014)在乳腺良恶性肿瘤之间差异有统计学意义。当肿瘤有穿支血流、边缘血流走行扭曲、边缘血流分布为周边穿入性血流、放射状血流、中央血流走行扭曲、中央有血流缺损时赋1分,曲线下面积(area under curve,AUC)为0.871,95%CI 0.799~0.943。赋分后,BI-RADS 4类乳腺肿瘤AUC由0.741提高到0.825。结论:UMA能够提高BI-RADS 4类乳腺肿瘤良恶性的诊断准确度,是诊断乳腺癌的有效血流检测手段。
文摘乳腺癌的发病率逐年递增,且发病年龄趋于年轻化。乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS)4类病变的恶性概率跨度较大(2%~95%),因只能通过活检明确病理诊断,故造成一些不必要的活检。近年来,乳腺超声领域涌现出许多新技术,包括弹性成像技术、超微血管血流成像技术、超声造影技术、自动乳腺全容积成像技术、“萤火虫”技术、S-Detect技术和超声影像组学技术等,其作为辅助手段为临床提供了更多的诊断信息,一定程度上提高了病变的检出率。本文旨在对乳腺超声新技术在BI-RADS 4类乳腺肿块良恶性鉴别诊断中的应用价值进行综述。
