超声BI-RADS联合超声弹性成像对乳腺肿块的诊断价值

The value analysis of ultrasound BI-RADS combined with ultrasound imaging in the diagnosis of breast masses

目的:探讨乳腺影像报告和数据系统(BI-RADS)与超声弹性成像(UE)以及两者联合使用对乳腺肿块的诊断价值。方法:选取2014年1月至2015年12月间就诊的125例乳腺肿块患者,共乳腺肿块142个,对所有肿块进行超声BI-RADS分类,并进行UE检查,以病理结果作为诊断金标准,观察两者单独应用及联合应用的敏感性、特异性、阳性预测值、阴性预测值和准确率。结果:本研究共142个病灶,其中经病理证实良性病灶81个,恶性病灶61个。UE三分法诊断结果显示,良性与恶性乳腺病灶的UE评分差异具有统计学意义(P<0.05),UE诊断恶性病灶的灵敏度为78.69%,特异度为81.48%,阳性预测值为83.54%,阴性预测值为76.19%。BI-RADS分类诊断结果显示,良性与恶性乳腺病灶的分类差异具有统计学意义(P<0.05),BI-RADS分类诊断恶性病灶的灵敏度为72.13%,特异度为77.78%,阳性预测值为70.97%,阴性预测值为78.75%。传统超声BI-RADS分类基础上结合UE进行调整,2种方法均与调整前结果进行比较,差异具有统计学意义(P<0.05)。结论:UE三分法可以提高BI-RADS分类对乳腺肿块良、恶性病灶诊断的敏感性、特异性。

Objective： To investigate the value of the breast imaging reporting and data analysis system（BIRADS） combined with ultrasonic elastography（UE） in the breast masses diagnosis. Methods： 142 breast tumors were collected from125 cases of patients with breast tumors from January 2014 to December 2015, then we classified all breast masses by the ultrasonic BI-RADS, and had a ultrasound elastography（UE） examination, which the pathological results were used as the gold standard for diagnosis, to study the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of two methods single-handed and combined application. Results： There were 142 lesions in this study, of which 81 were benign lesions and 61 were malignant lesions. UE three law diagnosis results show that statistically significant differences in UE scores between benign and malignant breast lesions（P0.05）, the sensitivity of UE in diagnosis of malignant lesions was 78.69%, the specificity was 81.48%, the positive predictive value was 83.54%, the negative predictive value was 76.19%. BIRADS classification results showed statistically significant differences in classification of benign and malignant breast lesions（P0.05）, the sensitivity of diagnosis of malignant lesions in BI-RADS classification was 72.13%, the specificity was 77.78%, the positive predictive value was 70.97%, the negative predictive value was 78.75%. On the basis of traditional ultrasonic BI-RADS classification combined with UE adjustment, the 2 methods were compared with the pre adjustment results, the difference was statistically significant（P0.05）. Conclusion： UE score method can improve the sensitivity and specificity of BI-RADS classification for diagnosis of benign and malignant breast lesions.