羅 俊

Jun LUO

四川省人民病院超音波科目

Department of Ultrasound, Sichuan Provincial People’s Hospital

キーワード :

【Objective】
We focus exclusively on BI-RADS-US 4 lesions, hypothesize that advanced BI-RADS-US combined with contrast-enhanced ultrasound（CEUS）can be established, and aim to investigate the diagnostic value of CEUS in breast lesions and reduce false-positive biopsies.
［Materials and Methods］
The clinical data of 208 breast lesions（118 benigns, 90 malignants）enrolled in this study. The enhancement appearences such as type, range and patterns were observed. Pathological findings at the patient’s definitive intervention served as the reference standard. Biopsy rates, accuracy, sensitivity, specificity, positive and negative predictive values of advanced BI-RADS-US were calculated. Furthermore, we analyzed the false-negative and false-positive cases and performed a model calculation to determine how CEUS could affect the proceedings in population screening.
【Results】
An advanced BI-RADS-US gave highly accurate risk estimates for malignant breast lesions as the pretest biopsy rate was 100％compared with the posttest was only 49.52％, which means there were 50.48％of biopsies should be avoided. The accuracy, sensitivity, specificity, positive and negative predictive value of the advanced BI-RADS-US was 90.38％, 92.78％, 85.96％, 84.91％and 93.33％．Malignant lesions（75/90, 83.33％）were more likely to be quick wash-in and slow wash-out vs. benign group（42/118, 35.59％）（P＜0.05）, and also with hyperenhancement（malignant 78/90, 86.67％vs. benign 46/118, 38.98％, P＜0.05）. Amplification enhanced range were much more likely to be seen（64/90, 71.11％）than benign group（16/118, 13.56％）（P＜0.05）, and most of these benign lesions were inflammatory or precancerous lesions.
【Conclusions】
CEUS yields additional diagnostic information in the evaluation of BI-RADS-US 4 lesions of the breast. Depending on advanced BI-RADS-US, the examiner can identify a low-risk group that can be vigilantly observed with biopsy if any change and may safely reduce the number of false-positive biopsies.