or Feng-Hua Li, Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dongfang Rd, 200127 Shanghai, China.
J Ultrasound Med. 2013 Oct;32(10):1805-14. doi: 10.7863/ultra.32.10.1805.
The purpose of this study was to evaluate the diagnostic efficacy of contrast-enhanced sonography for differentiation of breast lesions by combined qualitative and quantitative analyses in comparison to magnetic resonance imaging (MRI).
Fifty-six patients with American College of Radiology Breast Imaging Reporting and Data System category 3 to 5 breast lesions on conventional sonography were evaluated by contrast-enhanced sonography and MRI. A comparative analysis of diagnostic results between contrast-enhanced sonography and MRI was conducted in light of the pathologic findings.
Pathologic analysis showed 26 benign and 30 malignant lesions. The predominant enhancement patterns of the benign lesions on contrast-enhanced sonography were homogeneous, centrifugal, and isoenhancement or hypoenhancement, whereas the patterns of the malignant lesions were mainly heterogeneous, centripetal, and hyperenhancement. The detection rates for perfusion defects and peripheral radial vessels in the malignant group were much higher than those in the benign group (P < .05). As to quantitative analysis, statistically significant differences were found in peak and time-to-peak values between the groups (P < .05). With pathologic findings as the reference standard, the sensitivity, specificity, and accuracy of contrast-enhanced sonography and MRI were 90.0%, 92.3%, 91.1% and 96.7%, 88.5%, and 92.9%, respectively. The two methods had a concordant rate of 87.5% (49 of 56), and the concordance test gave a value of κ = 0.75, indicating that there was high concordance in breast lesion assessment between the two diagnostic modalities.
Contrast-enhanced sonography provided typical enhancement patterns and valuable quantitative parameters, which showed good agreement with MRI in diagnostic efficacy and may potentially improve characterization of breast lesions.
本研究旨在通过定性和定量分析相结合，评估超声造影在诊断乳腺病变中的效能，并与磁共振成像（MRI）进行比较。
对 56 例经常规超声检查诊断为美国放射学会乳腺影像报告和数据系统（BI-RADS）3-5 级的乳腺病变患者行超声造影和 MRI 检查，将超声造影和 MRI 的诊断结果与病理结果进行对照分析。
病理分析显示 26 例为良性病变，30 例为恶性病变。良性病变的超声造影增强模式主要为均匀、离心性、等增强或低增强，恶性病变的增强模式主要为不均匀、向心性、高增强。恶性组中灌注缺损和外周放射状血管的检出率明显高于良性组（P<0.05）。在定量分析方面，两组的峰值和达峰时间差异均有统计学意义（P<0.05）。以病理结果为参考标准，超声造影和 MRI 的敏感度、特异度和准确度分别为 90.0%、92.3%和 91.1%，96.7%、88.5%和 92.9%。两种方法的一致性率为 87.5%（56 例中的 49 例），一致性检验的κ 值为 0.75，表明两种诊断方法在评估乳腺病变方面具有高度一致性。
超声造影可提供典型的增强模式和有价值的定量参数，其在诊断效能上与 MRI 具有良好的一致性，可能有助于提高对乳腺病变的定性诊断。
