高频超声结合BI-RADS分级在乳腺肿瘤中的临床诊断价值

Clinical diagnostic value of high frequency ultrasound combined with BI-RADS grading in breast tumors

目的探究高频超声结合BI-RADS分级在乳腺肿瘤中的临床诊断价值。方法选择2015年2月～2017年8月在湖州市中心医院进行治疗的128例乳腺肿瘤患者(159个病灶)的临床病历资料进行回顾性分析,应用高频超声对其双侧乳房进行扫查,根据BI-RADS对乳腺病灶进行分级评价。将其BI-RADS分级情况与病理学结果进行对照分析,评价高频超声结合BI-RADS分级在乳腺肿瘤诊断中的临床价值。结果在159个乳腺肿瘤病灶中,经病理结果明确证实为良性病变98个,恶性病变61个。恶性病变病灶形态不规则、包膜不完整、边缘毛刺状、内部钙化以及腋下淋巴结异常的检出率明显高于良性病变病灶,差异有高度统计学意义(P<0.01)。恶性病变病灶的内部血流较良性病变病灶更加丰富,其Vmax水平、RI值明显高于良性病变病灶(P<0.01);两组的血流分级比较差异有高度统计学意义(P<0.01)。在BI-RADS分级诊断结果中,共计85个病灶被诊断为3级病灶(7个病理结果为恶性),35个被诊断为4级病灶(有17个病理结果为恶性),39个被诊断为5级病灶(37个病灶结果为恶性)。BI-RADS分级超声诊断的敏感度为88.52%(54/61),特异度为79.59%(78/98),准确度为83.02%(132/159)。结论 BI-RADS分级在诊断乳腺肿瘤中具有较高的敏感性和特异性。高频超声结合BI-RADS分级对于乳腺肿瘤的诊断定性以及指导治疗方案都具有重要意义。

Objective To research the clinical diagnostic value of high frequency ultrasound combined with BI-RADS grading in breast tumors. Methods From February 2015 to August 2017, the clinical records of 128 patients with breast tumors（159 lesions） in Huzhou Central Hospital were analyzed, retrospectively. The bilateral breasts were scanned with high frequency ultrasound, and the breast lesions were evaluated according to BI-RADS. The BI-RADS classification and pathological results were compared and analyzed. The clinical value of high frequency ultrasound combined with BI-RADS classification in the diagnosis of breast tumors was evaluated. Results Among 159 breast tumor lesions, 98 benign lesions were confirmed by pathological findings, and 61 malignant lesions were confirmed by pathological findings. The detection rate of malignant lesions in irregular shape, incomplete capsule, marginal burr, internal calcification and axillary lymph node abnormalities were significantly higher than those in benign lesions, the differences were statistically significant（P〈0.01）. The internal blood flow of malignant lesions was more abundant than benign lesions.The level of Vmax and RI value of malignant lesions were significantly higher than those of benign lesions, and the differences were statistically significant（P〈0.01）. A total of 85 lesions were diagnosed as grade 3 by the BI-RADS classification, which 7 lesions were malignant. There were 35 lesions were diagnosed as grade 4, which 17 lesions were malignant. 39 lesions were diagnosed as grade 5, which 37 lesions were malignant. The sensitivity of BI-RADS classification ultrasound was 88.52%（54/61）, the specificity was 79.59%（78/98）, and the accuracy was 83.02%（132/159）.Conclusion BI-RADS classification has high sensitivity and specificity in the diagnosis of breast tumors. The combination of high frequency ultrasound and BI-RADS classification have great significance for the diagnosis and characterization of breast tumor and the guidance of the treatment scheme.