乳腺BI-RADS 4类结节超声图像特征分析

Analysis of ultrasonographic features of BI-RADS 4 type breast nodules

目的:对超声诊断乳腺BI-RADS 4类结节的超声图像特征进行分析,并与病理结果对比研究。方法:回顾性分析2017年10月至2018年12月我院383例超声诊断为BI-RADS4类乳腺结节的超声图像特征,以手术或穿刺活检病理为金标准,分析良恶性乳腺结节在形态、边界、边缘、钙化、后方回声等方面的差异。结果:与病理诊断结果比较,383例BI-RADS4类结节中,超声诊断良恶性结节的符合率分别为81.5%与71.1%。良性结节患者平均年龄(46.7±10.5)岁,恶性结节患者平均年龄(55.5±12.4)岁,两组具有显著性差异(P<0.05);绘制ROC曲线得出,以46岁为截断值,其曲线下面积为0.695,诊断的敏感性为69.8%,特异性为60.3%。良性结节与恶性结节的超声图像对比:良性结节多表现为形态规则,边界清晰,边缘光滑、分叶,多不伴钙化;恶性结节多表现为形态不规则、边界模糊,边缘成角、毛刺,多伴微钙化(P<0.05)。良恶性结节间后方回声变化比较无显著统计学差异(P>0.05)。结论:超声诊断BI-RADS4类结节中,良恶性病变具有不同的声像图特征,可为临床医生进行乳腺结节良恶性诊断提供重要参考。

Objective To compare the ultrasonographic features of BI-RADS 4 type breast nodules diagnosed by ultrasound with pathological results.Methods From October 2017 to December 2018,383 cases with BI-RADS4 breast nodules diagnosed by ultrasound in our hospital were retrospectively analyzed.Based on the gold standard of surgery or biopsy pathology,the differences of benign and malignant breast nodules in morphology,border,edge,calcification and posterior echo were analyzed.Results Compared with pathological diagnosis results,the coincidence rate of ultrasound in the diagnosis of benign and malignant nodules in 383 cases was 81.5%and 71.1%,respectively.The mean age of patients with benign nodules was(46.7±10.5)years old,and that of patients with malignant nodules was(55.5±12.4)years old.There was a significant difference between the two groups(P<0.05).The ROC curve was drawn and the cut-off value was 46 years old,the area under the curve was 0.695,the sensitivity of diagnosis was 69.8%,and the specificity was 60.3%.Comparison of ultrasonic images between benign and malignant nodules:benign nodules usually show regular morphology,clear boundaries,smooth edges,lobulated and no calcification.Malignant nodules are often characterized by irregular morphology,blurred borders,angular edges,spiculated,and often accompanied by microcalcification(P<0.05).There was no statistically significant difference in the changes of posterior echo between benign and malignant nodules(P>0.05).Conclusion In the diagnosis of BI-RADS 4 type of nodules by ultrasound,benign and malignant lesions have different sonogram characteristics,which can provide an important reference for clinicians in the diagnosis of benign and malignant breast nodules.