Objective To explore the value of three-dimensional contrast-enhanced ultrasound angiography in the differential diagnosis of breast masses. Methods A total of 120 patients with breast masses who were treated in our hospital from July 2013 to February 2016 were selected as the research objects retrospectively, including 70 patients of benign tumor (benign group) and 50 patients of malignant tumor (malignant group) that confirmed by surgery and pathology. All patients were given conventional two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography during the diagnosis. Compared the imaging features of benign group and malignant group, and compared the diagnostic value of two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography for breast masses. Results Compared with benign group, the rates of irregular masses, unclear boundary, inhomogeneous echo, lateral shadowing, echo attenuation, and micro calcification in the malignant group were all higher (P<0.05). The three-dimensional contrast-enhanced ultrasound angiography scores in malignant group and benign group were significantly different with each other (P<0.05), the score of the malignant group was higher than that of benign group. The 2- and 3-score was common in benign group, but 4- and 5-score was common in malignant group. The diagnostic sensitivity of two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography for breast masses were 97.1% (68/70) and 98.6% (69/70) respectively, and the specificity were 80.0% (40/50) and 96.0% (48/50) respectively, the specificity of three-dimensional contrast-enhanced ultrasound angiography was significantly higher than that of two-dimensional ultrasound (P<0.05). Conclusion Two-dimensional ultrasound and three-dimensional contrast-enhanced ultrasound angiography both have a certain diagnostic value in the differential diagnosis of breast masses, but the three dimensional contrast-enhanced ultrasound angiography can get more information through assessment of richness of the microvascular in tumor tissue, so as to improve the diagnostic specificity and is worthy of popularization and application.
ObjectiveTo systematically review the value of the fine-needle biopsies in the diagnosis of benign and malignant breast nodules. MethodsA computer based online search was conducted in PubMed, The Cochrane Library (Issue 7, 2016), EMbase, CBM, CNKI, VIP, WanFang Data databases up to August, 2016 to collect the relevant diagnostic studies of the fine-needle biopsies for benign and malignant breast nodules. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed using Stata 12.0 and Meta-Disc 1.4 software.ResultsA total of 22 studies involving 24 496 patients were finally included. The results of meta-analysis showed that the pooled Sen, Spe, +LR, –LR, and DOR were 0.95 (95%CI 0.95 to 0.96), 0.96 (95%CI 0.96 to 0.96), 38.27 (95%CI 23.17 to 63.19), 0.05 (95%CI 0.03 to 0.07), 1 031.11 (95%CI 514.19 to 2 067.68), respectively. The AUC of SROC was 0.99 (95%CI 0.98 to 1.00).ConclusionThe current evidence indicates that the FNAC has high diagnostic value in the differential diagnosis of benign and malignant breast nodules.
目的 总结彩色多普勒超声（彩超）结合钼靶X线摄片标记定位对无临床体征乳腺肿块的定位诊断价值。 方法 2010年3月－2011年10月对48例彩超和钼靶X线检查发现可疑病灶而无任何临床体征的患者，在彩超引导下穿刺病灶金属导丝标记定位，并结合钼靶X线检查切除病灶，同时快速冰冻活检明确诊断。 结果 48倒中有11例确诊为乳腺癌（浸润性导管癌7例，导管内癌4例），37例为良性病变（纤维瘤5例，导管内乳头状瘤4例，乳腺腺病28例）。冰冻切片病理检查与术后石蜡病检结果一致。 结论 彩超引导下穿刺钢丝标记定位活检结合钼靶X线摄片，有效地解决了乳腺细小钙化和微小病灶活检术中精确定位和完整切除的难题，对无临床体征的微小乳腺肿块的诊断准确、可靠、实用。
目的:探讨乳腺良恶性肿块二维超声图像和彩色多普勒血流状况,提高乳腺肿块的超声诊断符合率。方法:回顾性分析105例乳腺肿块的二维及彩色多普勒超声图像特点。结果:本组恶性肿块37例,超声诊断和疑诊恶性肿块32例,符合率为865%(32/37);良性肿块68例,超声诊断良性肿块58例,符合率为853%(58/68)。乳腺良恶性肿块在形态、 边界、 包膜、 内部回声、 后方回声、 沙粒样钙化、血流形态分布,血流动力学等方面具有明显差异。结论:二维及彩色多普勒超声对良恶性乳腺肿块有较高鉴别诊断价值。
ObjectiveTo systematically review the diagnostic value of automatic breast volume scanner (ABVS) and handheld ultrasound (HHUS) for benign and malignant breast lesions.MethodsPubMed, EMbase, Web of Science, Biosis Preview, The Cochrane Library, WanFang Data, CNKI, VIP and SinoMed databases were electronically searched to collect studies on HHUS versus ABVS for benign and malignant breast lesions from inception to May 31st, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, and then, meta-analysis was performed by using Meta-Disc software.ResultsA total of 24 studies were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for HHUS were 0.83 (95%CI 0.82 to 0.85), 0.81 (95%CI 0.79 to 0.82), 19.71 (95%CI 14.93 to 26.01), 4.05 (95%CI 3.49 to 4.69), 0.22 (95%CI 0.18 to 0.26), and for ABVS were 0.90 (95%CI 0.89 to 0.92), 0.88 (95%CI 0.87 to 0.89), 76.86(95%CI 55.13 to 107.17), 7.40 (95%CI 6.07 to 9.04), 0.11 (95%CI 0.09 to 0.14), respectively. The areas under the summary receiver operating characteristic curves in the differentiation of benign and malignant breast lesions were 0.88 and 0.96 for ABVS and HHUS, respectively.ConclusionThe current evidence shows that ABVS has higher value than HHUS in the diagnosis of benign and malignant breast tumor. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
目的:探讨麦默通装置在乳腺微创外科中的应用。方法:44例共113个乳腺多发肿块均采用麦默通装置8G穿刺针在彩超引导下进行肿块切除术,术后送常规病理检查。结果:所有肿块均为完全切除,大小为0.4--5.5cm,56个为临床不可扪及的肿块,占49.6%,存在两种以上的病理改变9例,占20.5%,手术平均耗时12.5min,平均出血18.6mL。术后8例局部青紫,3例切口下血肿,均保守治疗后痊愈,无切口感染与瘢痕发生。结论:彩超引导下麦默通乳腺微创旋切术是一种早期诊治乳腺肿瘤安全、合理、有效、符合美学观点的方法,尤其适用于多发和无法触及的肿块。
ObjectiveTo systematically review the clinical value of the contrast-enhanced ultrasonic in the diagnosis of breast tumors. MethodsWe electronically and comprehensively searched the databases including The Cochrane Library (Issue 2, 2013), PubMed, CNKI, WanFang Data, Chaoxing medalink, VIP, and CBM for clinical research reports of diagnosing breast cancer with Contrast-enhance ultrasonic (all from foundation to May 2013). Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies according to the QUADAS items. The Meta-DiSc software (version 1.4) was used to conduct pooling on sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Heterogeneity test was performed and the summary receiver operating characteristic (SROC) curve was drawn for area under the curve (AUC). ResultsA total of 19 studies involving 1 161 participants were included. The results of meta-analysis showed that, specificity, the pooled sensitivity, positive likelihood ratio, negative likelihood ratio and DOR were 0.79 (95%CI 0.75 to 0.82), 0.86 (95%CI 0.83 to 0.89), 3.92 (95%CI 2.77 to 6.56), 0.18 (95%CI 0.13 to 0.26), and 25.86 (95%CI 13.77 to 48.55), respectively. The AUC of the SROC curve was 0.917 0. ConclusionThe current evidence shows that contrast-enhanced ultrasonic has high sensitivity and specificity in the diagnosis of preoperative benign and malignant breast mass, which indicates that it could be used as a good method to diagnosing breast tumors.
【摘要】目的探讨超声导向下Mammotome活检及旋切系统切除乳腺肿块的并发症及其处理。方法在超声导向下，利用Mammotome系统对乳腺肿块进行活检和切除，对出现的并发症进行及时的处理。结果46例患者的75个乳腺肿块被切除，病理证实68个为纤维腺瘤，7个为纤维腺病。术中并发症包括出血、血肿和胸大肌损伤，经及时处理后恢复，术后并发症为瘢痕形成。结论Mammotome乳腺肿块切除术具有创伤小、并发症少的优点，是一种有效的、不影响乳房外观的微创手术，超声监控能够减少和发现并发症并进行正确的处理。
ObjectiveTo explore the classification of ultrasound breast imaging reporting and data system (BI-RADS) classification combined with serum trefoil factor 1 (TFF1) and human growth differentiation factor 3 (GDF3) in the differential diagnosis of benign and malignant breast masses. MethodsThe prospective study collected 113 female patients with breast masses who got treatment in Tangshan People’s Hospital from September 2020 to September 2023. Ultrasound diagnostic equipment was applied for ultrasound BI-RADS classification, ELISA method was applied to detect serum TFF1 and GDF3 levels, Consistency Kappa test was used to compare the consistency of ultrasound BI-RADS classification, serum TFF1 and GDF3 alone and combined in the diagnosis of benign and malignant breast masses and pathological results, In addition, receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of the above indicators in the diagnosis of benign and malignant breast masses. ResultsAmong the 113 patients with breast mass, the pathological diagnosis showed benign mass in 48 cases and malignant mass in 65 cases. The serum levels of TFF1 [(1.62±0.25) μg/L vs (1.24±0.27) μg/L] and GDF3 [(118.62±21.73) ng/L vs (96.47±16.05) ng/L] in malignant patients were obviously higher than those in benign patients (P<0.001). There were 70 cases of malignant breast masses and 43 cases of benign breast masses according ultrasound BI-RADS classification combined with serum TFF1 and serum GDF3. The diagnosis consistency with pathological results was very high and Kappa value was 0.835 (P<0.001). The sensitivity and specificity of ultrasound BI-RADS classification combined with serum TFF1 and serum GDF3 in differential diagnosis of benign and malignant breast masses were 96.92% (63/65), 85.42% (41/48), respectively, the negative predictive value was 95.35% (41/43), and positive predictive value was 90.00% (63/70). The sensitivity, negative predictive value and accuracy were higher than those of ultrasonic BI-RADS classification and serum GDF3 alone (P<0.05), and the missed diagnosis rate was lower than that of ultrasonic BI-RADS classification and serum GDF3 alone (P<0.05). ConclusionsThe serum levels of TFF1 and GDF3 increase in patients with malignant breast masses. The combination of ultrasound BI-RADS classification and serum TFF1 and GDF3 can improve the sensitivity and accuracy of the diagnosis of benign and malignant breast masses, and reduce the missed diagnosis rate.