彩超多模式弹性成像技术鉴别诊断乳腺成像报告和数据系统3 类、4a 类乳腺病灶的价值

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摘要目的探讨彩超多模式弹性成像技术鉴别诊断乳腺成像报告和数据系统（BI-RADS）3 类、4a 类乳腺病灶的价值。方法选择2022 年4 月至2023 年4 月九江市中医医院收治的BI-RADS 3 类、4a 类60 例乳腺肿块患者作为研究对象，均行彩超多模式弹性成像技术检查。分析BI-RADS 3 类、4a 类乳腺病灶的超声特征及超声弹性成像指标，以手术病理活检结果为金标准，分析彩超多模式弹性成像技术诊断价值及其与病理诊断的一致性。结果 60 例乳腺肿块患者中良性肿块42 例，恶性肿块18 例；恶性肿块形态非平行生长、边缘不光整、内部回声不均匀、钙化比例均高于良性肿块，差异有统计学意义（P＜0.05）；恶性肿块弹性指数、弹性成像评分、弹性图像与灰阶图像上的面积比均高于良性肿块，差异有统计学意义（P＜0.05）；彩超多模式弹性成像技术诊断BI-RADS 3 类、4a 类乳腺病灶的灵敏度、特异度、阳性预测值、准确度、阴性预测值分别为90.48%、77.78%、90.48%、86.67%和77.78%。Kappa 检验显示：彩超多模式弹性成像技术与病理诊断的一致性尚可（Kappa 值=0.683，P＜0.001）。结论彩超多模式弹性成像技术在BI-RADS 3 类、4a 类乳腺良恶性病灶的诊断中有较高的临床价值，诊断结果与病理诊断一致性尚可，能够为临床诊治乳腺肿块提供指导。

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关键词 ：彩色多普勒超声, 多模式弹性成像技术, 乳腺成像报告和数据系统分类, 乳腺癌

Abstract：Objective To explore the value of color Doppler multimodal elastography technology in the differential diagnosis of breast imaging report and data system (BI-RADS)Class 3 and 4a breast lesions.Methods A total of sixty patients with BI-RADS 3 and 4a breast masses admitted to Jiujiang Hospital of Traditional Chinese Medicine from April 2022 to April 2023 were selected as the study objects,all of whom underwent color Doppler multimodal elastography examination.The ultrasound characteristics and ultrasound elastography indicators of BI-RADS 3 and 4a breast lesions were analyzed,and surgical pathological biopsy results as the gold standard were used to analyze the diagnostic value of color Doppler multimodal elastography technology and its correlation with pathological diagnosis.Results Among the 60 patients with breast masses,42 were benign masses and 18 were malignant masses.Malignant masses exhibit non parallel growth,irregular edges,uneven internal echoes,and a higher proportion of calcification compared to benign masses,with significant differences (P＜0.05).The elastic index,elastic imaging score,and the area ratio between elastic and grayscale images of malignant tumors were higher than those of benign tumors,with significant differences (P＜0.05).The sensitivity,specificity,positive predictive value,accuracy,and negative predictive value of color Doppler ultrasound multimodal elastography in the diagnosis of BI-RADS 3 and 4a breast lesions were 90.48%,77.78%,90.48%,86.67%,and 77.78%,respectively.Kappa test showed a positive correlation between the diagnostic results of color Doppler multimodal elastography and pathological diagnosis(Kappa=0.683,P＜0.001).Conclusion Color Doppler multimodal elastic imaging technology has high clinical value in the diagnosis of benign and malignant breast lesions in BI-RADS 3 and 4a categories.The diagnostic results are consistent with pathological diagnosis and can provide guidance for clinical diagnosis and treatment of breast masses.

Key words： Color Doppler ultrasound Multi mode elastic imaging technology Classification of breast imaging reports and data systems Breast cancer

基金资助:江西省卫生健康委科技计划项目（202311575）。

引用本文:

高俊；柯佩▲ ；曹莹. 彩超多模式弹性成像技术鉴别诊断乳腺成像报告和数据系统3 类、4a 类乳腺病灶的价值[J]. 中国当代医药, 2024, 31(17): 87-90.
GAO Jun KE Pei▲ CAO Ying. Value of color Doppler multimodal elastography in differential diagnosis of BI-RADS 3 and 4a breast lesions. 中国当代医药, 2024, 31(17): 87-90.

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