常规超声联合自动乳腺全容积成像对BI-RADS分类阳性预测值的诊断价值

The Diagnostic Value of Conventional Ultrasound Combined with Automated Breast Volume Imaging for Positive Predictive Value of BI-RADS Classification

目的评价自动乳腺全容积扫描（ABVS）和常规超声（HUS）对乳腺BI-RADS分类阳性预测值的对比分析。方法回顾性分析235例（共250个结节）HUS诊断为BI-RADS 3~5类,同时接受ABVS检查的患者,分别应用HUS和ABVS对乳腺病变进行BI-RADS分类,以病理结果为金标准。将ABVS和HUS的诊断资料进行数据收集并对比分析。结果 HUS对乳腺BI-RADS分类3级病变的诊断准确率、4级病变的阳性预测值、5级病变的阳性预测值分别为100.0%,43.1%,93.7%;HUS＋ABVS对乳腺3级病变的诊断准确率、4级病变的阳性预测值、5级病变的阳性预测值分别为100.0%,32.3%,94.8%.结论 ABVS和HUS对乳腺病变的诊断与病理结果有良好的一致性,在鉴别诊断中具有较高的应用价值,ABVS和HUS结合更有助于提高诊断准确率,但两者对BI-RADS 4级病变的诊断特异性较低。

Objective To evaluate the positive predictive value of automated breast volume scanning（ ABVS） and conventional ultrasound（ HUS） on BI-RADS classification of breast. Methods Totally 235 patients with 250 breast lesions who underwent both hand held ultrasound（ HUS） and ABVS were enrolled,were diagnosed as BI-RADS 3~ 5 by HUS. The accuracy of HUS and ABVS ＋ HUS were calculated to evaluate the BI-RADS classification of breast lesions,taking the pathology as the gold standard. Results HUS of breast BI-RADS classification grade 3 lesions diagnosis accurate rate,4 lesions of the positive predictive value,5 lesions positive predictive value were 100. 0%,43. 1%,93.7%; HUS ＋ ABVS of 3 breast lesions diagnosis accurate rate,4 lesions had a positive predictive value,5 lesions,the positive predictive value were 100. 0%,32. 3% and 94. 8%. Conclusion The ABVS and HUS of breast lesion diagnosis and pathology results are in good agreement,in differential diagnosis with higher application value. The combination of ABVS and HUS is more helpful to improve the diagnostic accuracy,but the diagnostic specificity of BI-RADS 4 grade lesions is low.