Qualitative, quantitative and combination score systems in differential diagnosis of breast lesions by contrast-enhanced ultrasound

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• 作者：YongMei Wang^a ; ^{wangyongmei-123@163.com" class="auth_mail" title="E-mail the corresponding author} ; Wei Fan^b ; ^{fanweitanzhen@sina.com" class="auth_mail" title="E-mail the corresponding author} ; Song Zhao^a ; ^{wshsongsong@126.com" class="auth_mail" title="E-mail the corresponding author} ; Kai Zhang^a ; ^{zk0827019@163.com" class="auth_mail" title="E-mail the corresponding author} ; Li Zhang^c ; ^{15063397202@163.com" class="auth_mail" title="E-mail the corresponding author} ; Ping Zhang^c ; ^{zpql_2014@126.com" class="auth_mail" title="E-mail the corresponding author} ; Rong Ma^a ; ^{marongw2000@163.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：CEUS ; contrast-enhanced ultrasound ; BI-RADS ; breast imaging reporting and data system ; RT ; rising time ; PI ; peak intensity ; MTT ; mean transit time ; AUC ; area under the curve ; WIS ; wash-in slope ; TTP ; time to peak ; ROC ; receiver operating characteristic
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：85
• 期：1
• 页码：48-54
• 全文大小：1214 K

文摘

To assess the feasibility of score systems in differential diagnosis of breast lesions by contrast-enhanced ultrasound (CEUS).

Methods

CEUS was performed in 121 patients with 127 breast lesions by Philips iU22 with Sonovue as contrast agent. Pearson Chi-square χ² test, binary logistic regression analysis and Student’s t-test are used to identify significant CEUS parameters in differential diagnosis. Based on these significant CEUS parameters, qualitative, quantitative and combination score systems were built by scoring 1 for benign characteristic and scoring 2 for malignant characteristic. Receiver operating characteristic (ROC) curve was applied to evaluate the diagnostic efficacy of different analytical methods.

Results

Pathological results showed 41 benign and 86 malignant lesions. Qualitative analysis and logistic regression analysis showed that there are significant differences in enhancement degree, enhancement order, internal homogeneity, enhancement margin, surrounding vessels and enlargement of diameters (P < 0.05) between benign and malignant lesions. Quantitative analysis indicated that malignant lesions tended to show higher peak intensity (PI), larger area under the curve (AUC) and shorter time to peak (TTP) than benign ones (P < 0.05). Qualitative score systems showed higher diagnostic efficacy than single quantitative CEUS parameters. The corresponding area under the ROC curve for qualitative, quantitative and combination score systems were 0.897, 0.716 and 0.903 respectively. Z test showed that area under the ROC curve of quantitative score system was statistically smaller than that of other score systems.

Conclusions

Quantitative score system helps little in improving the diagnostic efficacy of CEUS. While qualitative score system improves the performance of CEUS greatly in discrimination of benign and malignant breast lesions. The application of qualitative could develop the diagnostic performance of CEUS which is clinically promising.