探讨BI-RADS分级在超声诊断乳腺癌中的应用价值

The role of BI-RADS classification in ultrasonic diagnosis of breast cancer

目的:探讨超声乳腺影像报告和数据系统对诊断乳腺癌的应用价值。方法:选择患乳腺疾病并将行外科手术患者71例,应用高频彩色多普勒对双侧乳房进行扫查。根据BI-RADS对乳腺病灶进行分级,选择BI-RADS 3～5级的患者61例(78个病灶),将乳腺BI-RADS分级情况和病理切片结果进行比较和分析,评估BI-RADS分级对于鉴别乳腺癌的效能。结果:在61例患者(78个病灶)中,病理学活检结果显示:24个BI-RADS 3级的病灶中,良性20个(83.33%),恶性4个(16.67%);29个BI-RADS 4级的病灶中,良性3个(10.34%),恶性26个(89.66%);25个BI-RADS 5级的病灶中,良性0个(0),恶性25个(100%)。BI-RADS分级诊断乳腺癌的敏感度和特异度分别为92.73%、86.96%。BI-RADS 3～5级病灶在病变边缘、边界、回声、周围组织、钙化、血管分布、血流RI值间的差异均有统计学意义(P<0.01)。结论:BI-RADS分级诊断乳腺癌的敏感性和特异性较高。在高频彩色多普勒超声检查乳腺中,应用BI-RADS分级对于诊断乳腺癌和指导治疗方案具有重要的临床意义。

Objective： To study the role of BI-RADS classification（Breast imaging reporting and data system） in ultrasonic diagnosis of breast cancer.Methods： A total of 71 patients with breast diseases who would undergo surgery were selected for study.All the patients underwent bilateral breast examination with high-frequency color Doppler ultrasonography.According to BI-RADS classification,61 patients（78 breast lesions） with BI-RADS grade 3~5 were recruited.The diagnostic characteristics of high-frequency color Doppler ultrasonography about breast lesions with different BI-RADS were compared with the histopathological diagnosis.Then the efficacy of BI-RADS classification for the identification of breast cancer was assessed.Results： In all the 61 patients（78 breast lesions）,confirmed by histopathology,24 were BI-RADS grade 3,in which 20（83.33%） were benign,4（16.67%） were malignant.Twenty-nine breast lesions were BI-RADS grade 4,and histopathology confirmed 3（10.34%） were benign,26（89.66%） were malignant.Twenty-five lesions were BI-RADS grade 5,and all the lesions were malignant confirmed with histopathology（100%）.Sensitivity and specificity were 92.73% and 86.96% respectively in the diagnosis of breast cancer by BI-RADS classification.Statistical difference was found in BI-RADS grade 3,4,5 in margin,lesion boundary,acoustic feature,the changes of surrounding tissue,calcification in mass,vascularity in lesion blood flow and resistance index（RI）.Conclusion： The sensitivity and specificity of the BI-RADS classification were high in diagnosing breast cancer.It has important clinical significance for high-frequency color Doppler ultrasound in the diagnosis of breast cancer and treatment planning.