乳腺影像学报告及数据系统与超声造影和弹性成像联合应用鉴别乳腺病灶良恶性的价值

The value of breast imaging reporting and data system combined with contrast-enhanced ultrasonography and ultrasonic elastography for diagnosis of breast lesions

目的探讨乳腺影像学报告及数据系统（BIRADS）、超声造影及超声弹性成像（UE）3种超声检查方法对乳腺病灶的良恶性鉴别诊断价值。方法应用BIRADS、超声造影、UE 3种超声诊断方法对139例患者获病理证实的156个乳腺病灶进行检查。对3种方法单独使用、任意2种方法联合使用、3种方法联合使用的敏感性、特异性和准确性进行分析评价。结果病理检查结果：156个乳腺病灶中良性68例共80个病灶，恶性71例共76个病灶，1BIRADS评分：良性82个，恶性74个。超声造影检查：良性80个，恶性76个。UE检查：良性82个，恶性74个。单独以及任意2种方法联合使用诊断乳腺癌良恶性与病理相比均有统计学意义（均P＜0.05）。3种方法单独以及任意2种方法联合使用两两比较敏感性、特异性、准确性差异均无统计学意义（均P＞0.05）。而联合应用3种方法诊断乳腺恶性病灶的敏感性为93.4%、特异性为98.8%、准确性为96.1%，与单独以及任意2种方法联合使用比较差异均有统计学意义（均P＜0.05）。结论应用多种方法综合诊断乳腺肿瘤将明显提高诊断敏感性、特异性、准确性，有望成为乳腺超声诊断的发展方向。

Objective To assess the value of breast imagingreporting and data system（BIRADS）, contrastenhanced ultrasonography（CEUS） and ultrasonic elastography（UE） for diagnosis of breast lesions. Methods Totally 139 patients with 156 breast lesions confirmed by pathology were examined through BIRADS、CEUS and UE. The sensibility, specificity and accuracy of sole or combined use of the three methods was analyzed/assessed. Results Among the 156 breast lesions, pathologic examination confirmed 80 benign ones with 68 patients and 76 malignant ones with 71 patients; BIRADS showed 82 benign and 74 malignant; CEUS showed 80 and 76; UE showed also 82 and 74. There was no obvious difference in terms of sensibility, specificity and accuracy between sole use of one method and random use of two（P〉0.05）. However, combined use of three methods showed a sensibility of 93.4%, a specificity of 98.8% and an accuracy of 96.1%.Conclusion The combined use of BIRADS, CEUS and UE can increase the sensibility, specificity and accuracy in diagnosing breast tumors.