The Diagnostic Value Of Qualitative And Quantitative Analysis Of Contrast-enhanced Ultrasound In The Differentiation Of Benign And Malignant Scrotal Masses

Objective To explore the qualitative characteristics and quantitative analysis of Time Intensity Curve（TIC）of contrast-enhanced Ultrasound（CEUS）,to screen each indicator and establish a Logistic regression model to explore its diagnostic efficacy for scrotal masses.Methods We selected patients with scrotal swelling in the Inner Mongolia medical university affiliated hospital from September 2017 to March 2020,33 patients,a total of 34 nodules,pathological results obtained,preoperative do conventional ultrasound and contrast-enhanced ultrasound examination.Ultrasound imaging data of patients were recorded and retrospectively analyzed to observe the whole process of contrast,analyze the features of focal enhanced perfusion,and evaluate the qualitative indicators of contrast:enhancement mode,degree of enhancement,mode of enhancement,no enhancement zone in internal perfusion,and whether the enhanced boundary was enlarged.Record storage of dynamic contrast-enhanced ultrasound in import post-processing software,ultrasonography in scrotal mass selection interested area（region of interest,ROI）,within the ROI on contrast agent infusion process for automatic analysis,draw Time Intensity curve,line curve fitting to get ROI blood flow parameters,analyzing the characteristic of the quantitative parameters:increase the Slope（Ascending Slope,AS）,Peak strength,Peak Intensity,PI),Time of Arrival（concatenated Time,AT）,Time To Peak（TTP）,Area Under Curve（AUC）,and Descending Time/2（DT/2）.Qualitative data line by Fisher’s exact test comparison between groups,the quantitative data using t/t’inspection line comparison between groups,for each index selection,logistic equation,to end up in logistic model analysis indicators,draw the receiver-operating Characteristic curve（Receiver Operating Characteristic,ROC）,calculate the area under the curve,and evaluate its value in the diagnosis of benign and malignant neoplasm of the scrotum.Results The enhancement mode and degree of the qualitative indicators of contrast-enhanced ultrasound were statistically significant in the diagnosis of benign and malignant scrotal masses（P<0.05）.The enhancement mode and degree were used as qualitative indicators to enter the Logistic model.The regression equation was P=1/[1+e-^{（-2.813+2.964X1+4.124X2）}].Among the quantitative indicators,the slope of the ascending branch,the peak intensity,the arrival time and the area under the curve were statistically significant among benign and malignant scrotal masses.The index entered into the Logistic model for quantitative analysis was the peak intensity,and the regression equation P=1/[1+e-^{（-9.714+0.408Y2）}].The indicators with statistical significance in qualitative and quantitative indicators were taken as covariables for logistic regression analysis,and the index enhancement degree and peak intensity were entered into the final logistic model.The regression equation P=1/[1+e-^{（-11.061+3.320X2+0.416Y2）}],the ROC curve area of the equation was0.976,and the diagnosis efficiency was good.Conclusion（1）Contrast-enhanced ultrasound is helpful for the differential diagnosis of benign and malignant scrotal masses.（2）The enhancement mode,enhancement intensity and peak intensity of quantitative indicators of single-factor contrast-enhanced ultrasound have high diagnostic value in the diagnosis of scrotal masses.（3）Combining qualitative and quantitative indicators of contrast-enhanced ultrasound with higher diagnostic efficiency is better than single qualitative or quantitative indicators.