超声弹性成像对校正BI-RADS-US 3类及4类乳腺肿块的诊断价值

Value of BI-RADS-US rectified by ultrasound elastography in diagnosis of type 3 and type 4 breast lumps

目的分析超声弹性成像对校正乳腺超声影像报告数据系统(Breast Imaging and Reporting System Ultrasound,BI-RADS-US)3类及4类乳腺肿块的诊断价值。方法对常规BI-RADS-US分类法诊断为3类及4类的乳腺肿块用超声弹性成像进行校正,以病理结果为金标准,对比分析校正前后的BI-RADS-US分类法对乳腺肿块良恶性的鉴别诊断效能。结果常规BI-RADS-US分类法诊断乳腺良恶性肿块的灵敏度、特异度、准确度分别为75.6%、88.1%、83.8%,受试者工作特征(ROC)曲线下面积为0.836。经超声弹性成像校正后BI-RADS-US分类法的诊断灵敏度、特异度、准确度分别为82.9%、93.1%、90.8%,ROC曲线下面积为0.918。校正前后ROC曲线下面积比较差异有统计学意义(P<0.05)。结论弹性成像有助于提高超声对BI-RADS-US 3类及4类乳腺肿块良恶性的鉴别诊断效能。

Objective To analyze the value of Breast Imaging and Reporting System Ultrasound(BI-RADS-US)rectified by ultrasound elastography in diagnosis of type 3 and type 4 breast lumps.Methods Breast lumps of type 3 and type 4 diagnosed by conventional BI-RADS-US classification were diagnosed by ultrasound elastography as rectification.With the pathological results as the gold standard,the efficacies of BI-RADS-US classification were compared and analyzed in differential diagnosis of benign and malignant breast tumors before and after rectification.Results The sensitivity,specificity and accuracy of the conventional BI-RADS-US classification were 75.6%,88.1%and 83.8%respectively in diagnosis of benign and malignant breast tumors,and the area under the receiver operating characteristic(ROC)curve was 0.836.The sensitivity,specificity and accuracy of the BI-RADS-US classification with ultrasound elastography rectification were 82.9%,93.1%and 90.8%respectively,and the area under ROC curve was 0.918.There were significant differences in the areas under ROC curve before and after rectification(P<0.05).Conclusion Elastography is conducive to improving the diagnostic efficacies of ultrasound in the differential diagnosis of benign and malignant breast tumors of BI-RADS-US type 3 and type 4.