Diagnostic Value Of CEUS Combined With Mammography For Breast BI-RADS4 Type 4 Nodules

Objective: The prevalence of breast cancer is increasing year by year,but the range of benign and malignant breast BI-RADS 4 nodules is large,so early identification of BIRADS type 4 nodules is very important.This article mainly discusses the diagnostic value of contrast-enhanced ultrasound combined with mammography in the diagnosis of breast BI-RADS type 4 nodules,and the pathological results as the gold standard,analyzes the different enhancement features of contrast-enhanced ultrasound,and plots the timeintensity curve.Differences between benign and malignant breast BI-RADS type 4 nodules.Methods: A total of 125 cases of breast BI-RADS 4 lesions were found in the Department of Ultrasound,Department of Ultrasound,Yan’an University Hospital from October 2016 to October 2018.All patients underwent mammography and CEUS.The ultrasound contrast quantitative and qualitative enhancement features were retrospectively analyzed by two sonographers.The BI-RADS classification uses the latest version developed by the American Radiological Association 2013 as a classification standard.Draw the diagnostic boundary points of different diagnostic methods,draw ROC curves,and find the best diagnostic boundary points.The pathological results were used as the gold standard,and the diagnostic powers of conventional ultrasound,mammography,contrastenhanced ultrasound and mammography combined with CEUS were compared.The contrast-enhanced ultrasound contrast mode was used to analyze the difference of contrastenhanced features between benign and malignant nodules.P<0.05 was considered as statistically significant.Results: 125 breast BI-RADS 4 nodules were obtained,65 were malignant and 60 were benign.,and they are all single nodules.The mean age was malignant(48.9 ± 11.1)years old and the benign group(38.9 ± 8.5)years old.The diagnostic accuracy of the collected cases was analyzed,and the ROC curve of conventional ultrasound,mammography,contrast-enhanced ultrasound,contrast-enhanced ultrasound and mammography was obtained.The best diagnostic boundary was 4b,≥4b was malignant,<4b It is benign.The area under the ROC curve for the four diagnostic methods were 0.779,0.728,0.928,and 0.884,respectively.Further,the sensitivity,specificity,coincidence rate,positive predictive value and negative predictive value of conventional ultrasound diagnosis glandular BI-RADS 4 benign and malignant nodules were 81.5%,63.3%,72.8%,70.6%,76.0%,respectively.The sensitivity,specificity,coincidence rate,positive predictive value and negative predictive value of mammography for the benign and malignant tumors of the breast BI-RADS 4 were 75.4%,63.3%,69.6%,69.1%,70.4%,respectively.The sensitivity,specificity,coincidence rate,positive predictive value and negative predictive value of contrast-enhanced diagnosis of breast BI-RADS nodules were 95.3%,85.0%,90.4%,87.3%,and 94.4%.The compliance rate,sensitivity and specificity of CEUS were higher than those of MG,and the difference was statistically significant(P<0.05).Ultrasonography combined with mammography sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 96.9%,76.7%,87.2%,81.8%,95.8%,respectively.The diagnostic efficacy of CEUS combined with mammography was higher than that of MG,and the difference was statistically significant(P<0.05).The diagnostic value of contrast-enhanced ultrasound combined with mammography in the diagnosis of benign and malignant tumors of the breast BI-RADS4 has a good Kappa value of 0.742.In this group of patients,contrast-enhanced ultrasound(CEUS)enhancement features were compared with pathological findings.There were statistically significant enhancements between benign and malignant nodules: enhanced intensity,enhanced phase and uniformity(P<0.05);enhancements without statistical differences were: Enhanced order and integrity(P>0.05).Conclusion:1.ultrasound,mammography,CEUS,contrast-enhanced ultrasound combined with mammography X-ray have certain value in the diagnosis of benign and malignant tumors of BI-RADS type 4 nodules.2.Contrast-enhanced ultrasonography is more effective than mammography in the diagnosis of benign and malignant tumors of the BI-RADS type 4 nodules.3.Different enhancement features of breast contrast-enhanced ultrasound have high accuracy in the diagnosis of benign and malignant BI-RADS type 4 nodules,and have important clinical value in identifying benign and malignant breast nodules.4 contrast-enhanced ultrasound(CEUS)combined with mammography X-ray can significantly improve the accuracy of the diagnosis.