[Diagnostic value of contrast-enhanced ultrasound in breast lesions of BI-RADS 4].

Abstract

Objective: To investigate the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of BI-RADS 4 breast masses. Methods: A total of 72 patients were collected from the First Hospital of Shanxi Medical University from January 2016 to December 2017.79 breast masses were confirmed by biopsy or surgical pathology.All the masses were classified by BI-RADS according to conventional ultrasound and CEUS was performed in parallel.Based on the results of the CEUS predictive model, the benign and malignant features of the breast BI-RADS type 4 tumors were re-determined: (1) conventional ultrasound BI-RADS classification+ CEUS predictive model: both of them were malignant when malignant; (2) re-adjusting BI-RADS classification by CEUS predictive model: if the malignant CEUS predictive model, upgrade a class, if the benign CEUS predictive model, downgrade a class.The diagnostic efficiency of the two methods in breast masses of BI-RADS 4 was compared. Results: (1) There were 36 malignant masses and 43 benign masses in 79 breast masses.Diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the conventional ultrasound BI-RADS classification, CEUS predictive model, conventional ultrasound BI-RADS classification+ CEUS predictive model and the adjusted BI-RADS classification were 86.1%, 65.1%, 74.7%, 67.4%, 84.8%; 88.9%, 76.7%, 82.3%, 76.2%, 89.2%; 80.6%, 86.0%, 83.5%, 82.9%, 84.1%; 97.2%, 76.7%, 86.1%, 77.8%, 97.1%, respectively.(2) The area under the receiver operating characteristic (ROC) curve of conventional ultrasound BI-RADS classification, CEUS predictive model, conventional ultrasound BI-RADS classification+ CEUS predictive model and the adjusted BI-RADS classification was 0.756, 0.828, 0.833, 0.870, respectively.Before and after the adjustment of BI-RADS classification, the difference was statistically significant (Z=2.322, P<0.05). Conclusion: The diagnostic efficiency that CEUS predictive model adjusted classification of BI-RADS 4 breast masses is better, the method can reduce unnecessary biopsy.