The predictive value of conventional ultrasound and contrast-enhanced ultrasound for high-grade ductal carcinoma<em> in situ</em> of the breast

SHI Jianan; LI Fan; DU Lianfang; JIA Chao; LI Gang; CAI Yingyu; ZHAO Lei; NIU Qinghua nbsp

doi:10.19732/j.cnki.2096-6210.2023.06.002

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The predictive value of conventional ultrasound and contrast-enhanced ultrasound for high-grade ductal carcinoma in situ of the breast

更新时间：2025-12-15

- The predictive value of conventional ultrasound and contrast-enhanced ultrasound for high-grade ductal carcinoma in situ of the breast
- Vol. 32, Issue 6, Pages: 492-499(2023)
- 作者机构：
  
  上海交通大学医学院附属第一人民医院超声科,上海,201600
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2023.06.002
  CLC：
- Published Online：28 December 2023，
  
  Published：28 December 2023
- 稿件说明：
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施佳楠,李凡,杜联芳,等. 常规超声和超声造影对高级别乳腺导管原位癌预测价值的研究[J]. 肿瘤影像学, 2023, 32(6): 492-499 https://doi.

org/10.19732/j.cnki.2096-6210.2023.06.002
施佳楠,李凡,杜联芳,等. 常规超声和超声造影对高级别乳腺导管原位癌预测价值的研究[J]. 肿瘤影像学, 2023, 32(6): 492-499 https://doi. DOI： 10.19732/j.cnki.2096-6210.2023.06.002.

org/10.19732/j.cnki.2096-6210.2023.06.002 DOI：

摘要

目的：

探索常规超声及超声造影（contrast-enhanced ultrasound，CEUS）声像图表现对高级别乳腺导管原位癌（ductal carcinoma

in situ

，DCIS）的独立预测因素及预测价值。

方法：

回顾并分析2018年1月—2021年12月诊断为DCIS患者的临床及影像学资料。纳入患者均行手术后病理学检查，并有明确的核分级结果。纳入患者均具备术前1个月内完善且质量良好的常规超声和CEUS图像资料，以多因素logistic回归分析常规超声和CEUS上独立预测因素并计算预测效能。

结果：

最终94个单纯DCIS病变纳入研究，包括低级别23例、中级别41例及高级别30例。将中、低级别归为一组，高级别归为另一组，两组间患者年龄、病灶最大径、症状及淋巴结转移情况组间差异无统计学意义。常规超声上病变形态分类（即肿块样和非肿块样）及是否伴发微钙化组间差异均有统计学意义（

＜0.05），且微钙化为独立预测风险因素，其似然比（odd ratio，OR）为3.071，曲线下面积（area under curve，AUC）为0.636（

=0.014）。在CEUS上，增强均匀性、病变边缘存在放射状血管及增强后范围增大征象组间差异均有统计学意义（

＜0.05），其中，边缘放射状血管征象为独立预测因素，OR和AUC分别为3.319和0.640（

=0.013）。常规超声及CEUS两种模态联合预测高级别DCIS的灵敏度、特异度及AUC分别为46.7%，90.6%及0.686，联合后的特异度较单独常规超声或CEUS模态明显提升（

＜0.05）。

结论：

常规超声及CEUS声像图表现均有助于预测高级别DCIS，其中，常规超声的微钙化表现及CEUS的病变边缘放射状血管征象为独立预测因素，两者联合较单独模态可显著提高预测特异度。

Abstract

Objective:

To explore the independent predictive risk factors and their predictive value of conventional ultrasound and contrast-enha

nced ultrasound (CEUS) sonographic performance for high-grade ductal carcinoma

in situ

(DCIS) of the breast.

Methods:

Clinical and ultrasound imaging data of patients diagnosed with DCIS between January 2018 and December 2021 were retrospectively analyzed. Included patients underwent surgical resection to obtain final pathology with clear nuclear grading results. Included patients had preoperative well-established and good quality conventional ultrasound and CEUS imaging data within 1 month

and independent predictors on conventional ultrasound and CEUS were analyzed by multifactorial logistic regression and predictive efficacy was calculated.

Results:

Finally

94 simple DCIS lesions were included in the study

including 23 cases of low grade

41 cases of intermediate grade and 30 cases of high grade. Low and intermediate grade were grouped together and high grade were grouped together

and there were no significant differences in patient age

focus maximum diameter

symptoms and lymph node metastasis between the two groups. The morphological classification of lesions on conventional ultrasound (i.e.

mass-like and non-mass-like) and the presence of microcalcifications were significantly different between the groups (

＜0.05)

and microcalcifications were independent predictors of risk with an odd ratio (OR) value of 3.071 and an area under the curve (AUC) of 0.636 (

=0.014). On CEUS

there were significant differences between the groups of enhancement uniformity

presence of radial vessels at the edge of the lesion and signs of increased extent after enhancement (

＜0.05)

with radial vessels at the edge being an independent predictor (OR=3.319

AUC=0.640

=0.013). The combined modalities of conventional ultrasound and CEUS predicted high-level. The sensitivity

specificity and AUC of DCIS were 46.7%

90.6% and 0.686

respectively

and the specificity of the combination was significantly higher than that of conventional ultrasound or CE

US modality alone (

＜0.05).

Conclusion:

Both conventional ultrasound and CEUS sonographic manifestations can help to predict high-grade DCIS

with microcalcifications on conventional ultrasound and radial vessels at the lesion margin on CEUS as independent predictors

and the combination of both significantly can improve the predictive specificity compared with modality alone.

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The predictive value of conventional ultrasound and contrast-enhanced ultrasound for high-grade ductal carcinoma in situ of the breast

DOI：10.19732/j.cnki.2096-6210.2023.06.002

摘要

Abstract

关键词

Keywords

references