目的 探讨超声造影对乳腺癌前病变的诊断价值.方法 回顾性分析2016年1月至2017年4月由四川省人民医院组织的"乳腺结节超声造影前瞻性多中心研究"的465例患者(共465个病灶),包括69例乳腺癌前病变及396例其他类型良性病灶,分析病灶超声造影表现及造影预测模型,并计算其诊断乳腺癌前病变的敏感性、特异性和准确性.结果 乳腺结节超声造影预测模型诊断癌前病变的敏感性为60.9%,ROC曲线下面积为0.681.癌前病变主要表现为非向心性、均匀性高增强,增强后病灶增大;其他类型良性病灶主要表现为非向心性、均匀性高增强,增强后病灶大小不变.结论超声造影对乳腺癌前病变和良性病灶的鉴别诊断表现出了潜在价值,有助于临床医生对乳腺癌前病变提前采取干预措施.
Objective To evaluate the diagnostic value of contrast-enhanced ultrasound in breast precancerous lesions . Methods Retrospectively analyzed the contrast-enhanced ultrasound model and angiographic predictive model of 465 cases of the A prospective multicenter study of breast nodules contrast-enhanced ultrasound" that led the Sichuan Provincial People′s Hospital from January 2016 to April 2017 ,which included 69 cases of breast precancerous lesions and 396 other types benign lesions ,and the sensitivity ,specificity and accuracy of the diagnosis of breast precancerous lesions were calculated . Results The sensitivity of ultrasound predictive model for the diagnosis of precancerous lesions was 60 .9% and AUC was 0 .681 . Precancerous lesions mainly showed non-concentricity , increased homogeneity , and increased lesions;other types of benign lesions mainly showed non-centripetal ,high uniformity enhancement and lesion size unchanged . Conclusions Contrast-enhanced ultrasound shows a potential value in the differential diagnosis of precancerous lesions and other types of benign lesions ,that can help clinicians to take early intervention measures for breast precancerous lesions ,but there are still many problems to be solved .