乳腺BI-RADS-US分级对乳腺良恶性肿块的诊断价值

目的探讨超声乳腺影像报告与数据系统(breast imaging reporting and data system for ultrasonography,BI-RADS-US)对乳腺良恶性肿块的诊断价值。方法术前应用高频彩色多普勒超声对70例乳腺肿块患者进行双侧乳腺扫查,采用BI-RADS-US分级标准进行评价,选择BI-RADS-US3级、4级、5级患者共86个病灶,以手术或组织活检病理为"金标准"进行回顾性分析。结果应用BI-RADS-US分级标准进行评价,BI-RADS-US3～5级乳腺病灶在形态、方位、边缘、内部回声、后方回声特征、周围组织改变、肿块内部有无钙化及血流分布方面的差异有统计学意义(P<0.05)。86个病灶中,BI-RADS-US3级23个,恶性1个(4.35%);BI-RADS-US4级25个,恶性8个(32.00%);BI-RADS-US5级38个,恶性37个(97.37%)。BI-RADS-US分级诊断乳腺恶性病变的敏感度、特异度、阳性预测值(posiive predictive value,PPV)、阴性预测值(negative predictive value,NPV)分别为97.83%(45/46)、55.00%(22/40)、71.43%(45/63)、95.65%(22/23)。结论 BI-RADS-US使超声对乳腺肿块良恶性的评估更加规范、准确,对恶性病变的诊断具有较高的敏感度和阳性预测值,为临床进一步选择治疗方案有重要的指导价值。

Objective To explore the diagnostic value of benign and malignant breast masses with breast imaging reporting and data system for ultrasonography（BI-RADS-US）. Methods A total of 70 patients underwent bilateral breast examination with high-frequency color Doppler, and the results were evaluated with BI-RADS-US. Eighty-six breast lesions with BI-RADS-US grade 3,4,5 were evaluated and reviewed based on postoperative pathologic diagnosis. Results Significant defference were found between BI-RADS-US grade 3,4,5 in massa shape, orientation, margin, echo pattem, posterior acoustic features, the changes of surrounding tissue, microcalcification and vascularity in lesion（P﹤0.05）. In all 86 breast lesions, 23 were BI-RADS-US grade 3, and 1（4.35%） was pathologically confirmed to be malignant. 25 were BI-RADS-US grade 4, and 8（32.00%） were pathologically confirmed to be malignant. 38 were BI-RADS-US grade 5, and 37（97.37%）were malignant confirmed with histopathology. The sensitivity, specificity, positive predictive value（PPV） and negative predictive value（NPV） of BI-RADS-US in diagnosing malignant breast lesions was 97.83%（45/46）,55.00﹪（22/40）,71.43%（45/63）,95.65%（22/23）. Conclusion BI-RADS-US is standard and accurate for benign and malignant breast masses, it’s showed high sensitivity and PPV, and playing an important guiding value for the next step of treatment.