超声造影诊断乳腺占位性病变影响因素

目的 分析超声造影（CEUS）诊断乳腺占位性病变出现假阳性、假阴性结果的影响因素。方法 回顾性分析349例接受常规超声（US）、CEUS及乳腺X线摄影（MG）的女性乳腺单发占位性病变患者，以病理结果为金标准，将CEUS诊断结果分为真阳性、真阴性、假阳性和假阴性。采用单因素及多因素Logistic回归分析筛选CEUS出现假阳性、假阴性结果的影响因素。结果 349个乳腺病变中，良性病变205个，恶性病变144个。CEUS正确诊断127个恶性、170个良性病变，诊断敏感度为88.19%（127/144），特异度82.93%（170/205），准确率85.10%（297/349），假阳性率17.07%（35/205），假阴性率11.81%（17/144）。单因素及多因素Logistic回归分析结果显示，年龄、病变至乳头距离（DtP）、合并高危病变是CEUS假阳性的影响因素（P均<0.05）；而年龄、病灶最大径（LMD）与CEUS假阴性有关（P均<0.05）。结论 乳腺占位性病变患者年龄、DtP、是否合并高危病变与CEUS假阳性有关；年龄、病灶最大径与CEUS假阴性有关。

Impact factors of contrast-enhanced ultrasound in diagnosis of breast space occupying lesions

Objective To analyze the impact factors of false positive and false negative results of contrast-enhanced ultrasound (CEUS) in diagnosing space occupying breast lesions. Methods Data of 349 women with breast single lesions who underwent conventional ultrasound (US), CEUS and mammography (MG) were retrospectively analyzed. Taken pathological results as the gold standards, the diagnostic results of CEUS were evaluated as true positive, true negative, false positive and false negative, respectively. Univariate and multivariate Logistic regression analysis were used to screen the impact factors of false positive and false negative results of CUES. Results Among 349 breast lesions, 205 were benign lesions and 144 were malignant ones. CEUS correctly diagnosed 127 malignant lesions and 170 benign ones, with diagnostic sensitivity of 88.19% (127/144) and specificity of 82.93% (170/205), respectively. The accuracy of CEUS was 85.10% (297/349), the false positive rate was 17.07% (35/205), and the false negative rate was 11.81% (17/144). Univariate and multivariate Logistic regression analysis showed that age, the distance from lesion to nipple (DtP) and the associated high-risk lesions were the impact factors for false positive diagnosis (all P<0.05), while age, maximum lesion diameter (LMD) were associated with false negative diagnosis of CEUS (both P<0.05). Conclusion Age, DtP, with or not high-risk lesions were associated with false positive, while age and LMD associated with false negative CEUS diagnosis of space occupying breast lesions.