BI-RADS分类在乳腺良恶性病变诊断中的应用价值

Effectiveness of Application of BI-RADS Classification in Diagnosis of Benign and Malignant Breast Lesions

目的探讨乳腺影像报告和数据系统(BI-RADS)在乳腺良恶性病变诊断中的应用价值。方法对107例乳腺病变患者进行X线检查,运用BI-RADS分类系统对乳腺病变进行分类,并与病理结果进行对比,计算BI-RADS分类的准确度、敏感度、特异度、阳性预测值和阴性预测值。结果 107例患者中,恶性病变58例,良性病变49例。BI-RADS分类的准确度为70.1%(75/107),敏感度为98.3%(57/58),特异度为36.7%(18/49),总体阳性预测值为64.8%(57/88),0类、4类和5类的阳性预测值分别为46.7%(7/15)、43.9%(18/41)和100%(32/32),1类、2类和3类的阴性预测值分别为100%(4/4)、90.0%(9/10)和100%(5/5)。结论 X线诊断乳腺病变时,采用BI-RADS分类标准有利于提高乳腺癌的检出率,合理使用0类并结合临床检查能降低漏诊率。

Objective To study the effectiveness of application of the breast imaging reporting and data system （BI-RADS） in diagnosis of benign and malignant breast lesions. Methods Altogether 107 patients with breast lesions were scanned by X-Ray, classiifed according to BI-RADS and were further compared with pathologic ifndings. Moreover, the accuracy, sensitivity, speciifcity, positive predictive value （PPV） and negative predictive value （NPV） were calculated. Results Among 107 patients, there were 58 malignant and 49 benign lesions. The diagnostic accuracy, sensitivity and speciifcity of BI-RADS were 70.1%（75/107）, 98.3%（57/58） and 36.7%（18/49）. The general PPV of BI-RADS was 64.8%（57/88）. The PPV of Category 0, 4, 5 were 46.7%（7/15）, 43.9%（18/41） and 100%（32/32） respectively. The NPV of Category 1, 2 and 3 were 100%（4/4）, 90.0%（9/10） and 100%（5/5） respectively. Conclusion BI-RADS classiifcation was useful in mammographic diagnosis of breast lesions. With combination of the features of Category 0 and the clinical examinations, the omission diagnostic rate could be reduced.