不同性质乳腺病变CEUS特征、参数分析及对乳腺良恶性病变的鉴别价值OA

Objective:To explore the characteristics and parameters of contrast-enhanced ultrasound(CEUS)in different types of breast lesions,and analyze its value in distinguishing benign and malignant lesions.Methods:A total of 152 patients with breast lesions diagnosed by biopsy in our hospital from October 2021 to January 2023 were selected and divided into malignant lesion group(n=67)and benign lesion group(n=85).CEUS examination was performed using Canon Aplio i800 ultrasonic diagnostic instrumentand SonoVue contrast agent.The qualitative characteristics and quantitative parameters of CEUS[ascending branch slope,time to peak(TTP),mean transit time(MTT),descending branch slope,peak intensity(Peak％),regional blood flow(RBF),regional blood volume(RBV),and area under the curve]were compared between the two groups.The value of qualitative features and quantitative parameters in the differential diagnosis of malignant breast lesions was analyzed.Results:In the CEUS qualitative characteristics of malignant lesions group,the proportion of enlarged lesion range(98.51％vs.3.53％),unclear boundary after enhancement(80.60％vs.56.47％),irregular shape after enhancement(67.16％vs.50.59％),burr sign(83.58％vs.8.24％),perfusion defect(91.04％vs.14.12％),penetrating or distorting blood vessels(94.03％vs.21.18％)and high enhancement(76.12％vs.42.35％)was higher than that of benign lesions group(P＜0.05).The slope of ascending branch(7.11±1.75 dB/s vs.4.36±1.13 dB/s),Peak％(16.58±1.90 dB vs.12.57±1.44 dB)and area under the curve(925.76±160.42 dB/s vs.603.16±152.83 dB/s)in malignant lesions group were higher than those in benign lesions group,and the slope of descending branch(3.47±1.09 dB/s vs.5.03±1.46 dB/s)was lower than that in benign lesions group(P＜0.05).The 10 indexes of increased lesion range,clear boundary after enhancement,burr sign,perfusion defect,penetrating or distorting blood vessels,enhancement degree,slope of ascending branch,slope of descending branch,Peak％and area under the curve were all independent factors for differentiating benign and malignant breast lesions(P＜0.05).ROC curve analysis showed that the AUCof the logistic regression model integrating 10 independent factors of CEUS qualitative features and quantitative parameters in the differential diagnosis of malignant breast lesions was 0.902(95％CI:0.844～0.944),the sensitivity was 83.58％,and the specificity was 83.53％(P＜0.05).Conclusion:The application of Logistic regression model based on CEUS qualitative features and quantitative parameters in the identification of benign and malignant breast lesions can obtain higher diagnostic value.