超声及X线摄影BI-RADS诊断乳腺囊性及以囊性为主病变的价值

BI-RADS assessment on mammography and ultrasonography in cyctic lesions of brest

目的通过分析乳腺囊性肿块病变超声及钼靶表现并与病理对照,为临床提出进一步处理意见。方法回顾性分析乳腺囊性病变患者112例,共135个病灶。根据病灶内部囊性、实性成分比例和分布特点将其分为5型,计算每一类型恶性病灶阳性预测值,对这些病灶的良恶性行超声及X线摄影技术BI-RADS分级,分析相关性。结果超声分型中Ⅰ型39个(28.9%),Ⅱ型46个(34.1%),Ⅲ型13个(9.6%),Ⅳ型14个(10.4%),Ⅴ型23个(17.0%),阳性预测值分别为0、2.2%、30.8%、50.0%和56.5%,且各类型间阳性预测值有显著性差异,P=0.000,Ⅲ、Ⅳ、Ⅴ型阳性预测值明显高于Ⅰ型和Ⅱ型。超声和X线摄影技术BI-RADS分级之间具有显著性差异。结论超声与X线摄影技术BI-AIDS分级在诊断乳腺囊性病变中存在差异,联合应用有助于提高符合率。

Objective To analyze the relationship of breast cystic lesions with pathology and to recommend appropriate management for these lesions. Methods From December 2005 to December 2010,135 consecutive pathologically proven or long time followed cystic lesions were studied retrospectively. US features of lesions were classified into 5 types,and positive values（ PPVs）were calculated for each type. BI-RADS classification was used at ultrasonography and mammography. We analyzed the correlation between these factors. Results In ultrasonography,typeⅠ was 39（ 28. 9%）,typeⅡ 46（ 34. 1%）,type Ⅲ 13（ 9. 6%）,typeⅣ 14（ 10. 4%）,and typeⅤ 23（ 17. 0%）. The positive prognostic value for malignant in typeⅠ was 0%,typeⅡ was 2. 2%,typeⅢ was 30. 8%,type Ⅳ was 50%,and type Ⅴ was 56. 5%. There was statistically significant（ P = 0. 000）. The different between ultrasonography and mammography BI-RADS classification was statistically significant（ P = 0. 000）. Conclusion There is different between the diagnosis of breast cystic lesions by US and mammography with BI-RADS classification. Using both of two methods can help radiologist to determine management recommendations in clinic working.