超声造影对乳腺 BI-RADS 4类结节鉴别诊断价值

目的:研究超声造影对乳腺 BI-RADS 4类结节良恶性的鉴别诊断价值。方法:回顾性分析本院60例乳腺 BI-RADS 4类结节常规超声及超声造影检查资料，观察乳腺超声造影增强模式，分析良恶性结节之间超声造影增强特征的差异，并与穿刺活检或术后病理结果对照。结果:乳腺良恶性结节超声造影增强过程中其增强强度、增强时间、增强完整性方面有显著性差异（P<0.05），但在超声造影增强过程中增强顺序、增强均匀性方面尚未发现有显著差异（P>0.05）。常规超声 BI-RADS对乳腺良恶性结节诊断效能的的灵敏度、特异度、阳性预测值、阴性预测值分别为81.8%（18/22)、73.7%(28/38)、64%(18/28)和87.5%（28/32），超声造影判断乳腺 US BI-RADS 4类结节良恶性的灵敏度、特异度、阳性预测值、阴性预测值分别为90.9%(20/22)、86.8%(33/38)、88.0%(22/25)和94.3%（33/35）。超声造影对乳腺良恶性结节的诊断价值与病理结果的Kappa 值为0.75，具有较好的一致性。结论:乳腺超声造影不同增强特征对乳腺 BI-RADS 4类结节良恶性判断有较高的准确性，在指导临床治疗策略方面具有明确的应用价值。

Diagnostic value of contrast - enhanced ultrasound in diagnosing breast nodules in BI-RADS 4

Objective:To study the diagnostic value of contrast-enhanced ultrasound in diagnosing breast nodules in BI-RADS 4.Methods:Select 60 cases of breast nodules in US BI-RADS 4 in the department of ultrasound in our hospital by routine examination and ultrasound contrast-enhanced，categorizing performance enhancement pattern，and comparing with pathological results.Results:There were significant differences in enhancement intensity，enhancement phase and enhancement integrity in contrast enhanced contrast mode (P<0.05)，but there was no significant difference in enhancement order and enhancement uniformity in contrast enhanced model (P>0.05).The sensitivity，specificity，positive predictive value and negative predictive value of conventional ultrasound BI-RADS in the diagnosis of benign and malignant breast nodules were 81.8%(18/22)，73.7%(28/38)，64.3%(18/28) and 87.5%(28/32)，respectively.The sensitivity，specificity，positive predictive value and negative predictive value of the contrast enhanced wtrasound in BI-RADS 4 benign and malignant nodules were 90.9%(20/22)，86.8%(33/38)，88.0%(22/25) and 94.3%(33/35).The diagnostic value of contrast-enhanced ultrasound and benign and malignant nodules was 0.75，with a good agreement rate.Conclusion:Different contrast patterns of ultrasound contrast have good diagnostic value for benign and malignant nodules of BI-RADS 4.