Value Of Contrast-enhanced Ultrasound In Differentiating Benign And Malignant Breast Lesions

Objective: To compare the value of contrast-enhanced ultrasound(CEUS)five-point scoring system and predictive model with conventional ultrasound(CUS)in differentiating benign and malignant breast lesions.Methods: From September 2018 to December 2020,a total of 70 female patients with70 BI-RADS 4,5 lesions diagnosed by CUS in the First Affiliated Hospital of Dali University were included in the study.All of them underwent CEUS examination and obtained histopathological results by surgery or puncture.CEUS five-point scoring system and predictive model were used to differentiate benign and malignant breast lesions by retrospectively analyzing their different CEUS image features.The histopathological results were used as the "gold standard",the receiver operating characteristic curve(ROC)was constructed to compare the accuracy of CUS,CEUS five-point scoring system and prediction model.Their reliability was compared by Kappa-test with "Gold Standard".Results: 1.Of the 70 breast lesions,39 benign lesions(55.7%)and 31 malignant lesions(44.3%)were confirmed by histopathological diagnosis.The sensitivity,specificity,positive predictive value,negative predictive value,false positive rate and false negative rate of CUS,CEUS five-point scoring system and CEUS prediction model were80.65%,61.54%,62.50%,80.00%,38.47%,19.36%;83.87%,89.74%,86.67%,87.50%,10.26%,16.13% and 90.32%,87.18%,84.85%,87.18%,12.82%,9.68%;CEUS five-point scoring system and CEUS predictive model had higher specificity and lower false positive rate than CUS(P<0.05),but there was no statistically significant difference in the other diagnostic efficacy among three diagnostic methods(P>0.05);There was no statistically significant difference between CEUS five-point scoring system and CEUS predictive model in all the above diagnostic efficacy(P>0.05).2.The areas under ROC curve of CUS,CEUS five-point scoring system and prediction model were 0.711±0.063,0.868±0.048 and 0.888±0.044,among which CEUS five-point scoring system and CEUS prediction model were higher than CUS(Z1=2.305,Z2=1.982,P < 0.01);But there was no statistically significant difference in that between CEUS prediction model and five-point scoring system(Z3=0.031,P>0.05).3.The CUS and CEUS five-point scoring system were moderately consistent with "gold standard"(Kappa coefficients were 0.410 and 0.739);But the CEUS prediction model was highly consistent with "gold standard"(Kappa coefficient was 0.770).Conclusion: 1.CEUS prediction model and five-point scoring system have higher accuracy and reliability in differentiating benign and malignant breast lesions than CUS.The diagnostic advantage of CEUS lies in improving the specificity and positive predictive value and reducing the false positive rate.2.The accuracy of CEUS prediction model is equal to that of CEUS five-point scoring system,but the reliability of the former is better.