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目的构建乳腺良恶性病灶超声造影预测模型,评价其在乳腺影像报告与数据系统(BI-RADS)4类乳腺病灶恶性风险评估中的应用价值。方法 2013年1月至2014年7月在四川省人民医院接受乳腺超声造影检查的230例患者,共235个乳腺实性结节。所有患者经最终穿刺活检或者手术病理结果确诊。通过对既往文献关于乳腺良恶性病灶超声造影模式的分析及本课题组的前期研究和临床经验总结,构建乳腺良恶性病灶超声造影预测模型。以穿刺活检或手术病理结果作为金标准,计算预测乳腺良恶性病灶的超声造影模型鉴别诊断乳腺良恶性病灶的敏感度、特异度、准确性。结果本组235个乳腺结节,其中乳腺良性结节139个(59.2%),乳腺恶性结节96个(40.8%)。乳腺良恶性病灶超声造影预测模型鉴别诊断乳腺良恶性病灶的敏感度、特异度及准确性分别为87.01%、86.92%和86.99%。结论乳腺良恶性病灶超声造影模式存在差异。乳腺良恶性病灶超声造影预测模型可以更好地评估乳腺病灶恶性风险,尤其对BI-RADS 4类乳腺病灶评估更准确。
Objective To construct a predictive model of benign and malignant breast lesions by contrast echocardiography and evaluate its value in evaluating the malignant lesions of four types of breast lesions in the Breast Imaging Report and Data System (BI-RADS). Methods From January 2013 to July 2014, 230 patients underwent breast ultrasonography in Sichuan Provincial People’s Hospital with 235 solid breast nodules. All patients were confirmed by final biopsy or surgical pathology. Based on the previous literature on the analysis of benign and malignant breast lesions contrast echocardiography and the group’s preliminary study and clinical experience summary, the construction of benign and malignant breast lesions contrast-enhanced ultrasound contrast prediction model. Take the biopsy or pathological results as the gold standard, the sensitivity, specificity and accuracy of differential diagnosis of benign and malignant breast lesions by computed tomography were calculated. Results There were 235 breast nodules in this group, of which 139 (59.2%) had benign breast nodules and 96 (40.8%) had malignant breast nodules. The sensitivity, specificity and accuracy of differential diagnosis of benign and malignant breast lesions by CEUS were 87.01%, 86.92% and 86.99%, respectively. Conclusion There are differences in the modes of contrast-enhanced ultrasound between benign and malignant breast lesions. Breast benign and malignant lesions CEUS can better assess the malignant risk of breast lesions, especially for the assessment of BI-RADS type 4 breast lesions.