摘要
目的探讨乳腺磁共振Fischer’s评分结合MR影像报告数据系统（BI—RADS）鉴别乳腺病灶良恶性的临床应用价值。方法对我院乳腺外科触诊可疑乳腺肿物，乳腺钼靶或乳腺B超检查发现病变但不能明确诊断的患者行乳腺MRI检查。着重对MRI发现病变的4J4例女性患者进行分析，年龄25～7l岁，平均（45．1l±11．04）岁。按照2003年美国放射学会提出的针对乳腺MRBI—RADS对所发现的乳腺病灶进行分析，将病灶分为点状病灶、肿块及非肿块样强化病灶3大类。同时结合Fischer’S评分与MRBI—RADS对病变进行评估、分级，并与术后病理结果对照，计算Fischer’S评分与BI—RADS系统诊断病变的准确性。结果44例共发现47个病灶，乳腺MRI表现为点状强化病灶2个，肿块样强化病灶39个，非肿块样强化病灶6个。病理证实的良性病灶25个，恶性病灶22个。Fischer’S评分结合BI—RADS系统诊断的准确性为87％[（19＋22）／47]，敏感性为76％（19／25），特异性为100％（22／22），误诊率即假阳性率0％，漏诊率34％。结论Fischer’s评分结合BI—RADS系统将乳腺病变的形态学表现与动态增强表现有机结合，为乳腺癌的诊断规范了诊断步骤及标准，有助于乳腺病变的定性诊断，尤其对于MRI表现为肿块样病变良恶性的鉴别诊断准确性高于非肿块样病变。
Objective To investigate the value of Fischer＇ s scoring system combined with MR breast imaging reporting and data system （ MR BI RADS ） in differential diagnosis of breast lesions. Methods Forty four female patients （ age range 25 - 71years, mean age of 45.11 ± 11.04years） with breast lesions underwent MRI examination. According to MR BI RADS （2003 by ACR） , the breast lesions were divided into three main categories： focus or foci, masses and non mass like enhancement. We analyzed these lesions by Fischer＇ s scoring system and then compared the results with pathology. The sensitivity,specificity and accuracy of the Fischer＇ s scoring system combined with MR BI RADS in the diagnosis of breast lesions were calculated. Results 47 lesions were found in 44 patients. There were 2 foci, 39 masses and 6 non- mass like enhancements, of which histopathology proven 25 benign and 22 malignant. The correct rate, sensitivity, speci- ficity of Fischer＇ s scoring system and BI RADS was 87% [ （19 ± 22）/471, 76% （19/25） and 100% （22/22） respective- ly. The false positive rate and false negative rate were 0% and 34%. Conclusion Fischer＇ s scoring system combined with MR BI RADS is helpful for distinguishing benign from malignant breast mass lesions, which can provide an objective standard and criteria in diagnosis of breast cancer.
出处
《临床放射学杂志》
CSCD
北大核心
2013年第10期1432-1435,共4页
Journal of Clinical Radiology
基金
广东省自然科学基金资助项目(编号:10151001002000006)
