摘要
目的探讨乳腺影像报告与数据系统(breast imaging reporting and data system,BI-RADS)在超声检查可扪及乳腺肿块中的诊断价值。方法收集本院可扪及乳腺肿块、经超声检查并行手术活检的女性患者337例,比较其超声影像与病理检查结果。计算超声检查BI-RADS分级的灵敏度、特异度、正确率、阳性预测值(positive predictive value,PPV)、阴性预测值(negative predictive value,NPV)、阳性似然比、阴性似然比、约登指数。用χ2检验比较良、恶性征象乳腺肿块的恶性肿瘤百分率,并分析不同年龄段2级和3级病例良、恶性病变的分布特点。结果超声检查BI-RADS分级的灵敏度、特异度、正确率、PPV、NPV分别为95.7%、82.4%、84.3%、46.9%、99.2%,阳性似然比、阴性似然比、约登指数分别为5.44、0.05、0.78。在337例患者中,2～5级病变者恶性肿瘤百分率分别为0(0/145)、2.1%(2/96)、26.6%(17/64)、87.5%(28/32)。不同超声征象乳腺肿块的恶性肿瘤百分率如下:肿块形态不规则者中,占57.1%(36/63);肿块走向与皮肤不平行者中,占63.6%(14/22);肿块边界不清者中,占61.4%(43/70);肿块后方回声衰减者中,占63.3%(19/30);肿块有细小钙化者中,占75.0%(9/12);肿块内部回声不均匀者中,占47.6%(40/84)。在不同肿块形态、走向、边界、后方回声、细小钙化及内部回声的患者间,恶性肿瘤百分率的差异有统计学意义(P<0.05)。在2级和3级病例中,不同年龄段患者良、恶性病变分布的差异无统计学意义(P>0.05)。结论超声检查BI-RADS分级评估可扪及乳腺肿块有着较高的准确性,便于规范诊断与临床处理。
Objective To explore the diagnostic value of BI-RADS（breast imaging reporting and data system）in ultrosonography for palpable breast masses.Methods A total of 337female patients with palpable breast masses who were assessed by sonographic BI-RADS classification and underwent biopsy operation in our hospital were included in this study.Their pathology and sonography results were compared.The sensitivity,specificity,accuracy,positive predictive value（PPV）,negative predictive value（NPV）,positive likelihood ratio（＋LR）,negative likelihood ratio（-LR）,Youden＇s index for the cases,and malignant rates for each lesion category were calculated.Chi-square test was used to compare the malignant rates of breast masses with benign sonographic descriptor and breast masses with malignant sonographic descriptor,and the distribution of benign and malignant cases in category 2and 3was analyzed in different age groups.Results The sensitivity,specificity,accuracy,PPV and NPV of BI-RADS category were 95.7%,82.4%,84.3%,46.9%,99.2%,respectively.Positive LR,negative LR and Youden＇s index were 5.44,0.05 and 0.78,respectively.In the 337cases the malignant rates for category 2,3,4,5 were 0（0/145）,2.1%（2/96）,26.6%（17/64）and 87.5%（28/32）,respectively.The malignant rates of breast masses for each malignant descriptor were that irregular shape accounted for 57.1%（36/63）,nonparallel orientation 63.6%（14/22）,noncircumscribed margins 61.4%（43/70）,posterior shadowing 63.3%（19/30）,microcalcifications 75.0%（9/12）,and complex internal echo 47.6%（40/84）.With respect to shape,orientation,margins,posterior acoustic features,microcalcifications and internal acoustic features,there were statistically significant differences between the malignant rates of breast masses with benign sonographic descriptor and breast masses with malignant sonographic descriptor（P〈0.05）.There was no significant difference in the distribution of benign and malignant cases in category 2and 3 between different age groups（P 〉0.05）.Conclusions Sonographic BI-RADS classification is accurate for palpable breast masses,and it＇s convenient to the diagnosis and clinical management.
出处
《中华乳腺病杂志（电子版）》
CAS
2010年第4期16-19,共4页
Chinese Journal of Breast Disease(Electronic Edition)
