超声BI-RADS分类评估老年乳腺占位性病变的价值

Ultrasonic classification of BI-RADS preoperative evaluation of breast lesions occupied it

目的:分析超声BI-RADS分类标准在中老年乳腺占位病变患者术前评估的临床价值,为乳腺占位性病变患者的诊断和手术方案选择提供准确的信息,提高临床诊治质量。方法:选择2013年11月至2015年10月我院收治的中老年乳腺占位性病变患者840例作为研究对象,所有患者均采用超声BI-RADS分类标准对患者病情进行分类,所有患者均实施手术切除治疗,以手术病理诊断结果作为金标准,根据BI-RADS分类系统,将Ⅳ_a级和Ⅳ_b级假设为良性,Ⅳ_c级、Ⅴ级及Ⅵ级假设为恶性,采用四格诊断表,输入数据,计算超声BI-RADS分类方法与手术病理诊断结果的Kappa一致性及BI-RADS分类判断方法的敏感性、特异性和准确性。结果:840例患者超声BI-RADS分类结果:Ⅳ_a级:130例,Ⅳ_b级:150例,Ⅳ_c级:230例,Ⅴ级:150例,Ⅵ级:180例;手术后病理诊断结果恶性患者520例,良性320例。BI-RADS分类划分为恶性者510例,划分为良性者330例,BI-RADS分类法与手术病理诊断的Kappa一致性系数为0.891,该方法和手术病理诊断具有高度的一致性;BI-RADS分类法的敏感性96.15%、准确性96.43%、特异性96.88%。结论:超声BI-RADS分类法对乳腺占位性病变患者术前评估敏感性、准确性和特异性高,对患者手术方法的选择、整体治疗方案的选择具有良好的指导作用,作为乳腺占位性病变患者术前评估具有较高的临床价值。

Objective：To analyze the ultrasonic BI - RADS classification standard accounted for clinical evalua- tion of lesions of patients in elderly breast, breast lesions diagnosis and surgical planning to provide accurate informa- tion, improve the quality of clinical diagnosis and treatment. Methods：The November 2013 to 2015 year in October in our hospital in elderly breast lesions in 840 patients as the research object, and were treated with ultrasound BI - RADS classification criteria of patients,all patients underwent surgical resection,with surgical pathology results as the gold standard, according to the BI- RADS classification system, IVa and IVb is assumed to be benign, IVc and V and VI is assumed to be malignant, with four cases diagnosis table,input data, Kappa and BI -RADS ultrasound classifi- cation calculation BI - RADS classification method and pathological diagnosis results of the methods of judging the sensitivity specificity and accuracy. Results： Ultrasonic BI - RADS classification results of 840 patients ： Grade IVa ： 130 cases,grade IVb ：150 cases,grade IVc ：230 cases,grade V：150 cases,grade VI：180 cases. Pathological diagnosis after operation：520 cases of malignant;320 cases of benign patients. BI - RADS classification 510 cases were classi- fied as malignant,330 cases were benign, consistency coefficient Kappa BI- RADS classification and pathological di- agnosis was 0. 891 ,the method and the pathological diagnosis with a high degree of consistency. The sensitivity was 96.15% ,accuracy was 96.43%, and specificity was 96.88%. Conclusion： Ultrasound classification of BI - RADS lesions in patients with preoperative assessment of sensitivity, accuracy and specificity of high, a good guide the treat- ment of patients with surgical method selection, selection, as breast lesions were preoperative evaluation with high clin- ical value.