Application of contrast-enhanced ultrasonography in differentiating benign and malignant breast BI-RADS 4 nodules / 中国医师杂志

ABSTRACT

Objective:To explore the application value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant breast imaging reporting and data system (BI-RADS) type 4 nodules.Methods:The clinical data of 81 patients (82 nodules) with breast tumors admitted to the People′s Hospital of Inner Mongolia from February 2018 to January 2022 were retrospectively analyzed, all of whom were classified as BI-RADS. All patients underwent preoperative CEUS examination and underwent puncture biopsy or surgical treatment. Quantitative analysis software was used to draw a time intensity curve (TIC), quantitatively analyzing peak intensity (PI), area under the curve (AUC), baseline intensity (BI), time to peak (TTP), arrival time of contrast agent (AT), slope up (AS), half peak time (DT/2), and slope down (DS). We analyzed the differences in imaging parameters of the tumor edge zone in patients with benign and malignant breast tumors, and plotted the subject operating characteristic (ROC) curve for predicting benign and malignant breast tumors using statistically significant quantitative parameters. Area under the curve and cutoff values were calculated. The differences in imaging parameters between different regions of the tumor in the malignant breast group were analyzed.Results:PI and AUC at the margin of breast malignant tumor were higher than those of breast benign tumor (all P<0.001); There was no significant difference in PI, AUC in the central and surrounding tissues of breast malignant tumor, and BI, TTP, AT, DT/2, DS, AS in the central, marginal and surrounding tissues of breast malignant tumor compared with benign tumor of breast (all P>0.05). After drawing the receiver operating characteristic of PI and AUC at the edge of breast tumor, it was concluded that the area under the curve of PI in predicting benign and malignant breast tumors was 0.740 ( P<0.001), the sensitivity was 67.6%, the specificity was 77.8%, and the Youden′s J statistic was 0.453; The area under the curve of AUC was 0.743 ( P<0.001), the sensitivity was 67.6%, the specificity was 73.3%, and the Youden′s J statistic was 0.409. There was no statistically significant difference in PI and AUC at the edge of breast malignant tumors compared to the center of the tumor ( P=0.471, P=0.988); The PI and AUC of the center and edge of breast malignant tumors were higher than those of the surrounding breast tissue (all P<0.001). Conclusions:The blood flow perfusion characteristics of the marginal zone of breast tumors have certain diagnostic value in distinguishing between benign and malignant tumors, and can be used as a non-invasive indicator for distinguishing between benign and malignant breast tumors.