乳腺图像报告数据系统与超声弹性成像在乳腺良恶性病变诊断中的应用

Diagnostic values of breast imaging and reporting data system and ultrasonic elastography for benign and malignant breast lesions

目的探讨应用乳腺图像报告数据系统（BI-RADS）和超声弹性成像（uE）诊断乳腺良恶性病变的价值。方法2011年5月-2012年12月在首都医科大学附属北京世纪坛医院超声科共发现117例女性乳腺结节患者（122个乳腺结节）。对122个病理证实的乳腺结节进行BI-RADS超声分级和UE评分诊断，参照病理结果对比分析二者级二者联合诊断的敏感性、特异性，用ROC曲线下面积评价其联合应用价值。结果122个乳腺结节病理证实良性72个、恶性50个；按标准分级和评分诊断时，UE评分和二者联合与BI-RADS分级在特异性间差异有统计学意义（P〈0．05），敏感性间差异无统计学意义（P〉0．05），按Youden指数诊断则在敏感性间差异有统计学意义（P〈0．05），特异性间差异无统计学意义（P〉0．05）；UE评分和二者联合诊断间差异无统计学意义（P〉0．05）；ROC曲线下面积均〉0．7。结论BI-RADS分级和UE评分诊断乳腺病变均具有较好的应用价值，UE评分在某种程度上优于BI-RADS分级，而两者联合应用可能意义更大。

Objective To： explore the diagnostic values of breast imaging and reporting data system （BI-RADS） and ultrasonic elastography （UE） for benign and maglinant breast lesions. Methods A total of 122 breast lesions were studied with BI-RADS and UE scoring to compare the sensitivity and specificity according to the pathologic results. Receiver operating Characteristic （ROC） curves were used to assess the diagnostic value of BI-RADS, UE and combination. Results Among them, pathological examinations showed that there were 72 benign and 50 malignant cases. Statistically significant differences in specificity existed between BI-RADS lexicon （as ≥4） and UE or combination （P 〈 0. 05 ） while sensitivity si^owed no difference （P 〉 0. 05 ） ; Statistically significant differences in sensitivity existed between BI-RADS （ as ≥4B） and UE or combination （ P 〈 0.05 ） while there was no difference in specificity （ P 〉 0. 05 ） ; No statistically significant differences existed between UE or combination. The area under the ROC curve was above 0. 7. Conclusion Both BI-RADS and UE have a great diagnostic value for breast disease. UE is somewhat superior to BI-RADS. However, the value of combination may be more significant.