超声弹性成像联合BI-RADS-US分类对乳腺微小病灶的诊断价值

Value of ultrasound elastography combined with BI-RADS-US classification system in diagnosis of small breast lesions

目的探讨超声弹性成像技术(UE)联合乳腺超声影像报告和数据系统(BI-RADS-US)在鉴别诊断最大径≤10 mm乳腺微小病灶上的应用价值。方法对2014年3月至2015年3月于上海交通大学医学院附属新华医院崇明分院普外科行乳腺手术的99例患者共113个最大径≤10 mm的乳腺微小病灶进行BI-RADS-US分类,联合弹性成像评分后对其进行调整,结果与手术病理对照,比较联合调整前后诊断效能。结果联合UE评分对BIRADS-US分类进行调整,联合调整前的诊断准确度、敏感度、特异度分别为70.8%、82.1%、64.9%,均低于调整后的82.3%、92.3%、77.0%,但两者比较只有诊断准确度差异有统计学意义(P<0.05)。结论 UE联合BI-RADS-US分类能提高对乳腺微小病灶的良恶性鉴别能力。

Objective To investigate the value of ultrasound elastography（UE） combined with breast imaging reporting and data system（BI-RADS） in the diagnosis of small breast cancers with the maximal diameter≤10 mm. Methods A total of 113 small lesions（the maximal diameter≤10 mm） of 99 patients who underwent breast surgery in Department of General Surgery of Xinhua Hospital Chongming Branch Affiliated to Shanghai Jiaotong University School of Medicine from March 2014 to March 2015 were classified by BI-RADS. UE was combined and used to adjust the results. The results were further compared with those of postoperative pathology to evaluate the diagnostic efficiency in the diagnosis of small breast lesions. Results Based on the pathology results as the golden standard, the diagnostic accuracy, sensitivity and specificity of Ultrasound BI-RADS were 70.8%, 82.1% and 64.9%, respectively, which were lower than 82.3%, 92.3% and 77.0% of the combined use of ultrasound BI-RADS and ultrasound elastography. But only the difference in diagnostic accuracy was statistically significant（P〈0.05）. Conclusion The combination of UE and ultrasound BI-RAD can improve the ability of identifying benign and malignant small breast lesions.