彩超BI-RADS分类结合钼靶对乳腺肿瘤的诊断价值的对比研究

A comparative study of BI-RADS combined with molybdenum target in the diagnosis of breast cancer

目的探讨彩超乳腺影像报告和数据系统(BI-RADS)分类与钼靶及二者联合对乳腺肿瘤的诊断价值。方法选择2018年11月~2020年2月在我院接受诊治的240例乳腺肿瘤患者,其中经病理检查证实为乳腺癌患者106例,乳腺良性肿瘤患者134例。两组患者均接受了钼靶与彩超BI-RADS分类检查,比较乳腺癌与乳腺良性肿瘤的影像学特征,将彩超BI-RADS分类与钼靶单独检查结果及联合检查结果与病理检查结果进行对比。结果乳腺癌钼靶图像主要为片状致密影、肿块影、结节状影、微钙化影、致密模糊结节影。乳腺癌彩超图像主要为低回声肿块,形态不规则,边缘呈毛刺状,后方回声变化,微钙化等。钼靶对于肿块的微钙化灶显示率要显著高于超声(P<0.05)。钼靶诊断乳腺癌的敏感度为84.91%(90/106),特异度为91.04%(122/134),阳性预测值为88.24%(90/102),阴性预测值为88.41%(122/138),准确度为88.33%(212/240)。彩超诊断乳腺癌的敏感度为86.79%(92/106),特异度为96.27%(129/134),阳性预测值为94.85%(92/97),阴性预测值为90.21%(129/143),准确度为92.08%(221/240)。彩超结合钼靶诊断乳腺癌的敏感度为96.23%(102/106),特异度为90.30%(121/134),阳性预测值为88.70%(102/115),阴性预测值为96.80%(121/125),准确度为92.92%(223/240)。彩超结合钼靶诊断乳腺癌的敏感度显著高于单纯钼靶及彩超(P<0.05)。彩超结合钼靶诊断乳腺癌的阴性预测值显著高于单纯钼靶及彩超(P<0.05)。结论彩超BI-RADS类结合钼靶诊断乳腺肿瘤敏感度高,与单纯钼靶及彩超相比具有更高的诊断价值。

Objective To explore the diagnostic value of mammography report and data system(BI-RADS)classification of color Doppler ultrasound and molybdenum target in breast cancer.Methods From November 2018 to February 2020,240 patients with breast cancer were selected,including 106 patients with breast cancer confirmed by pathology and 134 patients with benign breast tumor.Both groups received color Doppler ultrasound BI-RADS grading examination and molybdenum target,and compared the imaging characteristics of breast cancer and breast benign tumor.The results of single examination and combined examination of color Doppler ultrasound BI-RADS and molybdenum target grading were compared with the pathological results.Results Molybdenum target images of breast cancer were mainly lamellar dense shadow,mass shadow,nodular shadow,microcalcification shadow and dense fuzzy nodular shadow.The main color ultrasound images of breast cancer are hypoechoic mass,irregular shape,burr like edge,echo change at the back,microcalcification and so on.The microcalcification rate of molybdenum target was significantly higher than that of ultrasound(P<0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of molybdenum target were 84.91%(90/106),91.04%(122/134),88.24%(90/102),88.41%(122/138)and 88.33%(212/240)respectively.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of color Doppler ultrasound were 86.79%(92/106),96.27%(129/134),94.85%(92/97),90.21%(129/143)and 92.08%(221/240)respectively.The sensitivity was 96.23%(102/106),the specificity was 90.30%(121/134),the positive predictive value was 88.70%(102/115),the negative predictive value was 96.80%(121/125),and the accuracy was 92.92%(223/240).The sensitivity of color Doppler ultrasound combined with molybdenum target in the diagnosis of breast cancer was significantly higher than that of molybdenum target alone and color Doppler ultrasound(P<0.05).The negative predictive value of molybdenum target combined with color Doppler ultrasound in the diagnosis of breast cancer was significantly higher than that of molybdenum target alone and color Doppler ultrasound(P<0.05).Conclusion Color Doppler ultrasound BI-RADS classification combined with molybdenum target has a good sensitivity in the diagnosis of breast cancer,and has a higher diagnostic value than molybdenum target alone and color Doppler ultrasound.