Pan Jiamin, Tong Wenjuan, Luo Jia, Liang Jinyu, Pan Fushun, Zheng Yanling, Xie Xiaoyan
Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China.
Br J Radiol. 2020 Aug;93(1112):20200195. doi: 10.1259/bjr.20200195. Epub 2020 Jun 2.
To compare the efficacy of contrast-enhanced ultrasound enabled reclassification of Breast Imaging Reporting and Data System (CEUS-BI-RADS) with MRI in the diagnosis of breast lesions with calcification.
A total of 52 breast lesions with calcification from 51 patients were detected by ultrasound as hyperechoic foci and categorized as BI-RADS 3-5. The 51 patients further underwent CEUS scan and MRI. The ultrasound-BI-RADS combined with CEUS 5-point score system redefined the classification of BI-RADS which was called CEUS-BI-RADS. The diagnostic efficacy of three methods was assessed by receiver operating characteristic (ROC) curve analysis. Histopathological assessment used as the gold-standard.
The sensitivities of Ultrasound-BI-RADS, MRI classification of BI-RADS (MRI-BI-RADS) and CEUS-BI-RADS were 85%, 90% and 95% without significant difference among the three modalities ( > 0.05). The diagnostic specificities of ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS were 78.1%, 78.1% and 96.8%, respectively ( < 0.05); and the accuracy were 80.7%, 82.6% and 96.1% for ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS, respectively ( < 0.05). The area under ROC (AUROC) in differentiation of breast lesions with calcification was 0.945 for CEUS-BI-RADS, 0.907 for MRI-BI-RADS and 0.853 for ultrasound-BI-RADS, with no significant difference among the three modalities ( > 0.05).
The CEUS-BI-RADS has a better diagnostic efficiency than MRI-BI-RADS in the differentiation of the breast lesions with calcification.
•CEUS is a better method in differentiation of breast lesions with calcification.•CEUS-BI-RADS increases the efficiency of diagnosis compared to MRI.
比较超声造影引导下的乳腺影像报告和数据系统重新分类（CEUS-BI-RADS）与磁共振成像（MRI）在诊断伴有钙化的乳腺病变中的疗效。
通过超声检测到51例患者共52个伴有钙化的乳腺病变为高回声灶，并归类为BI-RADS 3-5级。这51例患者进一步接受了超声造影扫描和MRI检查。超声-BI-RADS联合超声造影5分评分系统重新定义了BI-RADS分类，称为CEUS-BI-RADS。通过受试者操作特征（ROC）曲线分析评估三种方法的诊断效能。以组织病理学评估作为金标准。
超声-BI-RADS、MRI的BI-RADS分类（MRI-BI-RADS）和CEUS-BI-RADS的敏感度分别为85%、90%和95%，三种检查方法之间无显著差异（>0.05）。超声-BI-RADS、MRI-BI-RADS和CEUS-BI-RADS的诊断特异性分别为78.1%、78.1%和96.8%（<0.05）；超声-BI-RADS、MRI-BI-RADS和CEUS-BI-RADS的准确率分别为80.7%、82.6%和96.1%（<0.05）。CEUS-BI-RADS在鉴别伴有钙化的乳腺病变时的ROC曲线下面积（AUROC）为0.945，MRI-BI-RADS为0.907，超声-BI-RADS为0.853，三种检查方法之间无显著差异（>0.05）。
在鉴别伴有钙化的乳腺病变方面，CEUS-BI-RADS比MRI-BI-RADS具有更好的诊断效率。
•超声造影是鉴别伴有钙化的乳腺病变的更好方法。•与MRI相比，CEUS-BI-RADS提高了诊断效率。
