■硬化性腺病(SA)是一种常见的增生性良性病变,在乳腺中没有异型,在医学影像学上可能与浸润性导管癌(IDC)相似,导致它经常被误诊和虐待。因此,本研究的目的是评估多模态超声成像在鉴别SA和IDC中的诊断价值.
■多模态超声成像,包括自动乳房容积扫描(ABVS),弹性成像(EI),和彩色多普勒血流成像(CDFI),对120例连续患者进行了检查,包括122例乳腺病变(54例SA,68IDC)。所有病灶均经病理证实。比较两组多模态超声影像特征。基于ABVS的二元Logistic回归分析,EI,并进行CDFI,以制定逻辑回归方程来区分SA和IDC。ABVS的诊断性能,EI,CDFI,并通过受试者工作特征(ROC)曲线分析比较它们的组合。
■灵敏度,特异性,和ABVS的准确性,EI,CDFI,它们在区分SA和IDC方面的组合是,分别,75.00%,72.22%,和73.77%;86.76%,72.22%,和80.33%;73.53%,64.81%,和69.67%;和88.24%,74.07%,和81.97%。结合多模态超声成像得出的曲线下面积(AUC)为0.895(95%置信区间:0.827-0.943),高于ABVS,EI,和CDFI,AUC值分别为0.736、0.795和0.692,差异有统计学意义(ABVS与组合模型,P<0.001;CDFIvs.组合模型,P<0.001;EIvs.组合模型,P<0.001)。三种成像方式的诊断效能无显著差异(ABVS与EI,P=0.266;ABVSvs.CDFI,P=0.4671;EIvs.CDFI,P=0.051)。与IDC相比,钙化(16.67%vs.57.35%;P<0.001)和冠状面中的回缩现象(18.52%vs.57.35%;P<0.001)在SA患者中较少见,同时限制利润率(38.89%与5.88%;P<0.001),血管分布等级0-I(64.81%vs.26.47%;P<0.001),和弹性得分1-3(72.22%与13.24%;P<0.001)更常见于SA患者。SA患者明显比IDC患者年轻(43±11vs.54±11岁;P<0.001),SA患者的病变大小小于IDC患者(中位大小1.0cm;四分位距(IQR),0.9cmvs.中值尺寸1.3厘米;IQR,1.3cm;P<0.001)。
■初步结果表明,多模态超声成像可以提高SA的诊断准确性,并为SA和IDC的鉴别诊断提供额外信息。
UNASSIGNED: Sclerosing adenosis (SA) is a common proliferative benign lesion without atypia in the breast that may mimic invasive ductal carcinoma (IDC) on medical imaging, leading to it often being misdiagnosed and mistreated. Consequently, the purpose of this study was to assess the diagnostic value of multimodal ultrasound imaging in distinguishing SA from IDC.
UNASSIGNED: Multimodal ultrasound imaging, including automated breast volume scan (ABVS), elasticity imaging (EI), and color Doppler flow imaging (CDFI), were performed on 120 consecutive patients comprising 122 breast lesions (54 SA, 68 IDC). All lesions were pathologically confirmed. Multimodal ultrasound imaging features were compared between the two groups. Binary logistic regression analysis based on ABVS, EI, and CDFI was conducted to formulate a logistic regression equation for differentiating SA from IDC. The diagnostic performances of ABVS, EI, CDFI, and their combination were compared by the receiver operating characteristic (ROC) curve analysis.
UNASSIGNED: The sensitivity, specificity, and accuracy of ABVS, EI, CDFI, and their combination in differentiating SA from IDC were, respectively, 75.00%, 72.22%, and 73.77%; 86.76%, 72.22%, and 80.33%; 73.53%, 64.81%, and 69.67%; and 88.24%, 74.07%, and 81.97%. Combining multimodal ultrasound imaging yielded an area under the curve (AUC) of 0.895 (95% confidence interval: 0.827-0.943), which was higher than that of ABVS, EI, and CDFI, with AUC values of 0.736, 0.795, and 0.692, respectively, and the difference was statistically significant (ABVS vs. combined model, P<0.001; CDFI vs. combined model, P<0.001; EI vs. combined model, P<0.001). There was no significant difference in the diagnostic efficacy among the three imaging modalities (ABVS vs. EI, P=0.266; ABVS vs. CDFI, P=0.4671; EI vs. CDFI, P=0.051). Compared with those in IDC, the calcification (16.67% vs. 57.35%; P<0.001) and retraction phenomena in the coronal planes (18.52% vs. 57.35%; P<0.001) were less common in patients with SA, while circumscribed margin (38.89% vs. 5.88%; P<0.001), vascularity grade 0-I (64.81% vs. 26.47%; P<0.001), and elasticity scores 1-3 (72.22% vs. 13.24%; P<0.001) were more frequently found in patients with SA. Patients with SA were significantly younger than were patients with IDC (43±11 vs. 54±11 years; P<0.001), and the lesion size was smaller in patients with SA than in those with IDC (median size 1.0 cm; interquartile range (IQR), 0.9 cm vs. median size 1.3 cm; IQR, 1.3 cm; P<0.001).
UNASSIGNED: The preliminary results suggested that multimodal ultrasound imaging can improve the diagnostic accuracy of SA and provide additional information for differential diagnosis of SA and IDC.