弹性指数差在鉴别乳腺影像报告数据系统3～5类乳腺肿块良恶性中的应用

Application of elastic index difference in identification of benign and malignant masses of breast imaging reporting and data system 3—5

目的探讨弹性指数差(EID)鉴别乳腺影像报告数据系统(BI-RADS)3~5类肿块良恶性的应用价值。方法回顾分析164例经病理证实的BI-RADS 3~5类乳腺肿块患者(193个病灶)的超声检查资料。通过弹性成像定量分析软件测定肿块与正常腺体间的EID。以EID≥2.5判断为恶性,重新调整BI-RADS分类。绘制ROC曲线并计算曲线下面积(AUC)。比较BI-RADS联合EID与单独采用BI-RADS分类诊断乳腺恶性肿块的AUC及诊断准确率。结果以病理结果为金标准,单独采用BI-RADS诊断乳腺恶性肿块的敏感度、特异度、准确率分别为96.00%(72/75)、67.80%(80/118)、78.76%(152/193);BI-RADS联合EID诊断乳腺恶性肿块的敏感度、特异度、准确率分别为97.33%(73/75)、83.05%(98/118)、88.60%(171/193)。BI-RADS联合EID的AUC(0.931)高于单独应用BI-RADS的AUC(0.875),差异有统计学意义(Z=2.06,P<0.05);且2种方法的诊断准确率差异亦有统计学意义(χ~2=15.21,P<0.05)。结论 BI-RADS联合EID对鉴别乳腺肿块良恶性较单纯采用BI-RADS更具优势。

Objective To evaluate the application value of elastic index difference（EID）in identifying benign or malignancy masses of breast imaging reporting and data system（BI-RADS）3—5.Methods Data of 193 lesions in 164 patients with ultrasonic diagnosed as BI-RADS 3—5 breast masses were retrospectively analyzed.All the cases were confirmed pathologically.The EID of masses and normal glands were measured with elastography quantitative analysis software.BIRADS 3—5 breast masses were diagnosed as malignant when EID≥2.5,which was the criteria for BI-RADS reclassification.ROC curve was drawn,and the area under the curve（AUC）was calculated.The diagnostic accuracy and AUC of malignant breast tumors with the methods of BI-RADS and BI-RADS combined with EID were compared.Results Taking pathological results as gold standard,the sensitivity,specificity,accuracy of BI-RADS in detecting malignant tumors were96.00%（72/75）,67.80%（80/118）,78.76%（152/193）,and those of BI-RADS combined with EID were 97.33%（73/75）,83.05%（98/118）,88.60%（171/193）,respectively.The AUC of BI-RADS combined with EID（0.931）was higher than that of BI-RADS（0.875;Z=2.06,P〈0.05）.The statistical difference of accuracy was found between BI-RADS and BI-RADS combined with EID methods（χ^2=15.21,P〈0.05）.Conclusion The combination of BI-RADS and EID is better than simple using BI-RADS in identifying benign or malignancy of breast tumors.