超声弹性成像应变率比值对乳腺实性小肿物BI-RADS分类的影响

Effect of ultrasound elastography strain ratio on classification of small breast mass BI-RADS

目的探讨超声弹性成像应变率比值(SR)对乳腺实性小肿物(≤20 mm)BI-RADS分类的诊断价值。方法对58个乳腺实性小肿物进行超声BI-RADS分类和SR测定,并结合SR对常规BI-RADS分类情况重新进行分类,将上述诊断与病理结果进行比较,构建ROC曲线,比较BI-RADS分类和结合SR的BI-RADS分类对乳腺肿物恶性风险评估能力。结果常规BI-RADS分类与结合SR的BI-RADS分类诊断乳腺实性小肿物的灵敏度、特异度、准确性分别是73.68%、71.79%、72.41%与89.47%、89.74%、89.66%。结合SR的BI-RADS分类诊断乳腺病变的ROC曲线下面积为0.881,明显高于BI-RADS分类的0.757(Z=2.650,P<0.01)。结论结合SR的BI-RADS分类能明显提高对乳腺实性小肿物诊断的准确性,并能提高对4类乳腺实性小肿物的诊断特异度,有效减少不必要的术前活检。

Objective To explore the diagnostic value of ultrasound elastography strain ratio（SR）on the classification of small breast mass BI-RADS（≤20 mm）.Methods Conventional ultrasound BI-RADS was used to classify 58 small breast mass and measure SR of those neoplasm,then reclassifying the conventional classification of those 58 small breast mass with the combination of SR. The above-mentioned ultrasound diagnosis and pathology results were compared,and ROC curve was built. Then,risk assessment ability of BI-RADS classification and combination of SR and BI-RADS classification for malig-nant breast neoplasm were compared. Results The sensitivity,specificity and the accuracy rate of the BI-RADS were 73. 68%,71.79%,72.41% respectively,and those of the BI-RADS combined with SR were 89.47%,89.74% and 89.66% re-spectively in the diagnosis of breast cancer. The area under ROC curve of the BI-RADS classification combined with SR in the diagnosis of breast lesions was 0.881,which was significantly higher than that（0.757）of the BI-RADS classification（Z =2. 650,P〈0.01）.Conclusion Combination of SR and BI-RADS can significantly improve the diagnostic accuracy of the small breast neoplasm and diagnosis of specific degrees of four kinds of small breast mass,and effectively reduce unnecessary preoperative biopsy.