Section Discrepancy and Diagnostic Performance of Breast Lesions in Two-dimensional Ultrasound by Dynamic Videos versus Static Images
Section Discrepancy and Diagnostic Performance of Breast Lesions in Two-dimensional Ultrasound by Dynamic Videos versus Static Images
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DOI：
10.15212/bioi-2021-0021
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Dinghong Yang;Xiaoyun Xiao;Haohu Wang;Huan Wu;W. Qin;Xiaofeng Guan;Q. Jiang;B. Luo
中科院分区：
文献类型：
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作者：
Dinghong Yang;Xiaoyun Xiao;Haohu Wang;Huan Wu;W. Qin;Xiaofeng Guan;Q. Jiang;B. Luo
背景资料：二维超声可对具有典型声像图特征的乳腺良恶性病变作出准确诊断。然而，非典型病变的诊断仍然是一个挑战。大多数不典型病变因探头方向不同而具有不同的声像图特征。因此，基于超声医师凭经验收集的静态图像对超声特征的解释可能是不准确的。方法：收集468个乳腺病灶的二维超声图像，分别采用静态图像和垂直切面的动态图像进行对比分析。使用乳腺成像和报告数据系统（BI-RADS®）US词典。以3级为分界点，将两个垂直平面的BI-RADS分级定义为3级与4A、4 B、4C、5级。结果：共纳入良性病变315例，恶性病变153例。在静态和动态观察中，分别有53和50个病灶存在切片差异。无论是动态观察还是静态观察，良性病变与病理切片不符的比例均显著高于恶性病变（P < 0.05），病理切片不符与病理组织学检查结果的关联系数为0.2。无论良、恶性病变，动态图像对导管改变的显示均优于静态图像（P < 0.05）。动态影像对恶性病变钙化和结构变形的检出率明显高于静态影像（P < 0.05）。良性病变静态图像与动态图像对“边缘”的判读差异有统计学意义（P < 0.05）。静态图像水平、静态图像矢状、动态视频水平和动态视频矢状的曲线下面积分别为0.807、0.820、0.837和0.846。结论：乳腺病变在二维超声图像上存在切面差异，动态图像的特异性高于静态图像（P < 0.05）。动态影像观察能更准确地反映病变特征，提高超声对不典型乳腺病变鉴别诊断的特异性。
Background: Benign or malignant breast lesions with typical ultrasonic characteristics could be easily and correctly diagnosed with two-dimensional ultrasound (2D US). However, diagnosis of atypical lesions remains a challenge. Most atypical lesions have different ultrasonographic features with probe direction variation. Thus, the interpretation of ultrasonographic features based on static images empirically collected by sonographers might be inaccurate. We aimed to investigate the section discrepancy and diagnostic performance of breast lesions in 2D US by dynamic videos versus static images.Methods: Static images and dynamic videos based on two perpendicular planes of 468 breast lesions were collected and evaluated. The Breast Imaging and Reporting Data System (BI-RADS®) US lexicon was used. Category 3 was used as the cut-off point, and section discrepancy was defined as two perpendicular planes showing different BI-RADS categories (3 versus 4A, 4B, 4C, and 5).Results: This retrospective study included 315 benign and 153 malignant lesions. There were 53 and 50 lesions with section discrepancy during static and dynamic observations, respectively. The proportion of benign lesions with section discrepancy was significantly higher than that of malignant lesions (P < 0.05) either in dynamic or static observation, and the contingency coefficient was 0.2 between section discrepancy and histopathology. Duct changes were more clearly depicted in dynamic videos than in static images (P < 0.05) both in malignant and benign lesions. Calcification and architectural distortion were more sensitively detected by dynamic videos than with static images (P < 0.05) in malignant lesions. The interpretation of “margin” significantly differed in benign lesions between static images and dynamic videos (P < 0.05). The areas under the curve of static image-horizontal, static image-sagittal, dynamic video-horizontal, and dynamic video-sagittal were 0.807, 0.820, 0.837, and 0.846, respectively. The specificities of dynamic videos were higher than those of static images (P < 0.05).Conclusion: Breast lesions have section discrepancy in 2D US. Observations based on dynamic videos could more accurately reflect lesion features and increase the specificity of US in the differentiation of atypical breast lesions.