The Diagnostic Value Of Contrast-Enhanced Ultrasound Combined With BI-RADS In Breast Lesions With Calcification Or Punctate Hyperechoic

Objective :With pathological diagnosis as the ’ gold standard ’,the value of contrast-enhanced ultrasound(CEUS)combined with breast imaging reporting and data system(BI-RADS)and conventional ultrasound(US)combined with BI-RADS in the differential diagnosis of breast lesions with calcification or punctate hyperechoic was compared.Methods :Sixty patients who underwent US and CEUS examination at the same time in our hospital from January 2021 to December 2022 were selected and compared with the results of biopsy or surgical pathology.US-BI-RADS 3,4a,4b,4c,5 types of breast lesions with calcification or punctate hyperechoic were included in the study.Firstly,according to the fifth edition of ACR TI-RADS classification criteria in 2013,the breast lesions with calcification were described and classified.Among them,4b,4c and 5 were malignant,and 3 and 4a were benign.Then the lesion was examined by CEUS and the image was scored by 5 points.Finally,the US-BI-RADS classification was adjusted according to the contrast score,and the CEUS-BI-RADS classification based on CEUS was obtained.Among them,4b,4c,and 5 were malignant,and 3 and4 a were benign.The accuracy,sensitivity,specificity,missed diagnosis rate and misdiagnosis rate,negative and positive predictive values of CEUS-BI-RADS and US-BI-RADS were compared with pathological results.The diagnostic efficacy of the two diagnostic methods for breast lesions with calcification or punctate hyperechoic was tested.SPSS statistical software was used for statistical analysis of relevant data,and P < 0.05 was considered statistically significant.Results :1.The pathological diagnosis confirmed that 60 lesions included 34(56.67 %)in the benign group and 26(43.33 %)in the malignant group.The accuracy,sensitivity,specificity,missed diagnosis rate and misdiagnosis rate,negative and positive predictive values of the two diagnostic methods for breast cancer were : US-BI-RADS,70.00 %,80.77 %,61.76 %,19.23 %,38.24 %,80.77 %,60.76 %;CEUS-BI-RADS,88.33 %,84.62 %,91.18 %,15.38 %,8.82 %,88.57 %,88.00 %;compared with US-BI-RADS,CEUS-BI-RADS had higher accuracy,sensitivity,specificity,negative and positive predictive values,and lower missed diagnosis rate and misdiagnosis rate(P < 0.05).2.The area under the ROC curve of US-BI-RADS and CEUS-BI-RADS was0.713 ± 0.068 and 0.879 ± 0.050,respectively.The area under the ROC curve of CEUS-BI-RADS was higher than that of US-BI-RADS(t = 15.2343,P < 0.05).Conclusion :1.In the differential diagnosis of benign and malignant breast lesions with calcification or punctate hyperechoic,the accuracy of CEUS combined with BI-RADS is better than that of US-BI-RADS.The diagnostic advantage of CEUS-BI-RADS is to significantly improve the sensitivity,specificity,negative and positive predictive value,reduce the rate of missed diagnosis and misdiagnosis.2.The area under the ROC curve of CEUS combined with BI-RADS was higher and the diagnostic efficiency was better.