乳腺彩色多普勒超声检查、乳腺触诊成像与乳腺X射线摄影对BI-RADS 4类结节良恶性的鉴别诊断

Differential Diagnosis of Benign and Malignant of BI-RADS 4 Nodules by Mammary Gland Color Doppler Ultrasonography,Mammary Gland Sure Touch and Mammography

目的:分析乳腺彩色多普勒超声检查(CDS)、乳腺触诊成像与乳腺X射线摄影联合诊断乳腺影像报告和数据系统(BI-RADS)4类乳腺结节良恶性的效能。方法:选取2021年6月—2022年8月赣南医学院第一附属医院收治的300例(300个结节)BI-RADS 4类结节患者,依据病理检查结果将患者分为恶性组(n=150)与良性组(n=150),对所有患者均行乳腺CDS、乳腺触诊成像及乳腺X射线摄影检查。以病理检查结果为“金标准”,统计分析乳腺CDS、乳腺触诊成像与乳腺X射线摄影联合诊断BIRADS 4类乳腺结节良恶性的效能。结果:300例BI-RADS 4类乳腺结节患者中,乳腺CDS共检出131例恶性,乳腺触诊成像共检出134例恶性,乳腺X射线摄影共检出128例恶性,三者联合共检出148例恶性。乳腺CDS、乳腺触诊成像联合乳腺X射线摄影检查BI-RADS 4类结节的敏感度[97.33%(146/150)]、准确度[98.00%(294/300)]、阴性预测值[97.37%(148/152)]均高于三者单独检测,差异均有统计学意义(P<0.05),但三者特异度、阳性预测值比较,差异均无统计学意义(P>0.05)。Kappa检验显示,乳腺CDS、乳腺触诊成像联合乳腺X射线摄影检查结果与“金标准”检查结果的一致性极好(Kappa=0.960,P=0.000)。结论:乳腺CDS、乳腺触诊成像联合乳腺X射线摄影诊断BI-RADS 4类结节的良恶性效果显著,具有较高的检出准确度。

Objective:To analyze the efficacy of mammary gland color doppler ultrasonography(CDS),mammary gland sure touch and mammography combined with breast imaging reporting and data system(BIRADS)for diagnosis of benign and malignant of BI-RADS 4 nodules.Method:A total of 300 patients(300 nodules)with BI-RADS 4 nodules admitted to First Affiliated Hospital of Gannan Medical University from June 2021 to August 2022 were selected and divided into malignant group(n=150)and benign group(n=150)according to pathological examination results.All patients were examined by mammary gland CDS,mammary gland sure touch and mammography.The results of pathological examination as the"gold standard",the combined diagnosis efficiency of mammary gland CDS,mammary gland sure touch and mammography in BI-RADS 4 breast nodules was analyzed.Result:Among the 300 patients with BI-RADS 4 breast nodules,a total of 131 malignant cases were detected by mammary gland CDS,134 malignant cases were detected by mammary gland sure touch,128 malignant cases were detected by mammography,and 148 malignant cases were detected by combination of the three.The sensitivity[97.33%(146/150)],accuracy[98.00%(294/300)]and negative predictive value[97.37%(148/152)]of mammary gland CDS,mammary gland sure touch combined with mammography were higher than those of the three detection alone,the differences were statistically significant(P<0.05),but there were no significant differences in the specificity and positive predictive value of the three(P>0.05).Kappa test showed that the results of mammary gland CDS,mammary gland sure touch combined with mammography were very consistent with the results of"gold standard"examination(Kappa=0.960,P=0.000).Conclusion:Mammary gland CDS,mammary gland sure touch combined with mammography have a significant effect on the diagnosis of BI-RADS 4 breast nodules with high detection accuracy.