改良Fischer’s评分法对乳腺疾病的诊断价值

Value of improved Fischer's scoring system in diagnosis of breast lesions

目的:探讨乳腺MRI改良Fischer’s评分法在鉴别乳腺良恶性病变中的应用价值。方法:104例患者(共109个病灶)均行常规MRI平扫、动态增强扫描及DWI检查,均经手术或穿刺活检证实。Fischer’s评分法及改良Fischer’s评分法按MRI乳腺影像报告和数据系统(BI-RADS-MIR)分级判定良恶性。计算并比较Fischer’s评分法及改良Fischer’s评分法对乳腺疾病的诊断效能。结果:Fischer’s评分法对乳腺疾病的诊断敏感度、特异度、准确率分别为100%、67.9%、84.4%;改良Fischer’s评分法的诊断敏感度、特异度、准确率分别为100%、79.2%、89.9%。结论:改良Fischer’s评分法能明显提高MRI对乳腺疾病的诊断特异性和准确率,且保持了很高的诊断敏感性。

Objective:To investigate the value of improved Fischer’s scoring system in differential diagnosis of breast lesions.Methods:104 patients(109 lesions)proven by operation or biopsy received dynamic contrast enhancement and diffusion weighted imaging.Fischer’s scoring system and BI-RADS-MRI were used to distinguish the benign lesions from the malignant in Fischer’s scoring system method.The optimal boundary value of ROC curve was set as the threshold in DWI.Improved Fischer’s scoring system and BI-RADS-MRI were used to distinguish the benign lesions from the malignant in improved Fischer’s scoring system method.The diagnostic efficacy of DWI,Fischer’s scoring system method and improved Fischer’s scoring system method were calculated and compared.Results:The sensitivity,specificity and diagnostic accuracy of DWI,Fischer’s scoring system method and improved Fischer’s scoring system method were 82.1%,77.4%,79.8%,100%,67.9%,84.4%and 100%,79.2%,89.9%,respectively.Conclusion:Improved Fischer’s scoring system method could raise the specificity and diagnostic accuracy and to guarantee the sensitivity of MRI in diagnosis of breast lesions.