乳腺小肿块超声BI-RADS分级的临床应用价值

Clinical value of ultrasonic BI-RADS classification in small breast neoplasm

目的探讨超声乳腺影像报告和数据系统（BI-RADS）分级在乳腺小肿块临床诊断中的应用价值。方法收集2011年5月至2013年12月间于我院外科行手术治疗的113例乳腺小肿块（长径≤2 cm）高频多普勒彩色超声BI-RADS分级资料,比较BI-RADS 3～5级间的病灶在超声特征上的差异,并分析其与病理诊断间的关系。结果 BI-RADS 3～5级患者共99例。术后病理证实,21例BI-RADS 3级病灶中良性肿瘤20例,恶性肿瘤1例;41例BI-RADS 4级病灶中良性肿瘤10例,恶性肿瘤31例;37例BI-RADS 5级病灶中良性肿瘤3例,恶性肿瘤34例。不同分级病变在病灶边缘、边界、回声、周围组织改变、病灶内血管生成、血流阻力指数间差异均有统计学意义（P〈0.05）。超声BI-RADS分级诊断乳腺恶性肿瘤的阳性预测值为83.33%、灵敏度为98.48%、特异度为60.61%、ROC曲线下面积为0.901。结论超声BI-RADS分级诊断乳腺恶性小肿块的准确性较高,在乳腺恶性肿瘤的早期诊断和治疗指导中具有重要的临床应用价值。

Objective To investigate the clinical application of ultrasonic BI-RADS classification in small breast neoplasm. Methods A total of 113 small breast neoplasm lesions（length≤2 cm） from May 2011 to Dec. 2013 were enrolled in the study, and their data of ultrasonic BI-RADS classification were collected. The differences of ultrasonic features between BI-RADS classification 3 and 5 were compared, and then the relationship between BI-RADS classification and pathological diagnosis was analyzed. Results Ninety-nine lesions were judged in BI-RADS classification between 3 and 5. According to the postoperative pathological results, there were 20 benign tumors and 1 malignant tumor among the 21 breast lesions of BI-RADS grade 3, 10 benign tumors and 31 malignant tumor among the41 breast lesions of BI-RADS grade 4, 3 benign tumors and 34 malignant tumor among the 37 breast lesions of BI-RADS grade 5. Statistically significant difference was found between BI-RADS grade 3, 4, 5 in margin, lesion boundary, posterior acoustic feature, the changes of surrounding tissue, vascularity in lesion and blood flow resistance index（RI）. The positive predictive value, sensitivity and specificity was 83.33%, 98.48% and 60.61%, respectively.The area under receiver operating characteristic curve was 0.901. Conclusion Ultrasonic BI-RADS classification has a high accuracy in the diagnoses of small breast neoplasm. It has a high application value in the early diagnosis and treatment of breast malignant tumor.