乳腺造影评分法校正分类对乳腺肿块的鉴别价值

Value of correcting the classification of mammography scoring method in distinguishing benign and malignant breast masses

目的探讨乳腺造影评分法校正分类对乳腺BI-RADS 4类肿块良恶性的鉴别价值。方法选取2020年6月-2022年10月在安徽省立医院收治的186例乳腺病变患者(共193个病灶),均进行常规超声及超声造影检查,比较常规超声、超声造影评分法校正后BI-RADS分类、乳腺肿块良恶性鉴别结果及病理结果,并绘制ROC曲线分析超声造影评分法校正分类后及常规超声对BI-RADS 4类肿块良恶性的诊断价值。结果常规超声分别判断出118个良性病变和75个恶性病变;使用超声造影评分法校正分类后分别判断出106个良性病变及87个恶性病变;常规超声判断乳腺病变良恶性的灵敏度、特异度、阳性预测值、阴性预测值、AUC分别为74.68%、85.96%、78.67%、83.05%、0.803;超声造影评分法校正分类后判断乳腺病变良恶性的灵敏度、特异度、阳性预测值、阴性预测值、AUC分别为88.61%、85.09%、80.46%、91.51%、0.868。结论使用乳腺超声造影评分法校正BI-RADS 4类肿块分类可减少漏诊误诊病例,可在不影响灵敏度的情况下减少不必要的穿刺活检,在鉴别乳腺肿块良恶性中具有较高的诊断价值。

Objective To explore the value of correcting the classification of mammography scoring method in distinguishing benign and malignant breast BI-RADS type 4 masses.Methods 186 patients with breast lesions(a total of 193 lesions)admitted to Anhui Provincial Hospital from June 2020 to October 2022 were selected,and underwent routine ultrasound and contrastenhanced ultrasound examination.The BI-RADS classification,the differential results of benign and malignant breast masses by routine ultrasound and after correcting the classification using contrast-enhanced ultrasound scoring method,and pathological results were compared.Receiver operating characteristic curve(ROC)was drawn to analyze the diagnostic value after correcting the classification using contrast-enhanced ultrasound scoring method and by conventional ultrasound for benign and malignant BI-RADS type 4 masses.Results Routine ultrasound identified 118 benign lesions and 75 malignant lesions respectively.After correcting the classification using contrast-enhanced ultrasound scoring method,106 benign lesions and 87 malignant lesions were identified respectively.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC of routine ultrasound in the diagnosis of benign and malignant breast lesions were 74.68%,85.96%,78.67%,83.05%,and 0.803 respectively.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC after correcting the classification by contrast-enhanced ultrasound scoring method in the diagnosis of benign and malignant breast lesions were 88.61%,85.09%,80.46%,91.51%,and 0.868.Conclusion The use of contrast-enhanced breast ultrasound scoring method to correct the classification of BI-RADS type 4 breast masses can reduce missed diagnosis and misdiagnosed cases,reduce unnecessary puncture biopsy without affecting the sensitivity.And this therapy has high diagnostic value in differentiating benign and malignant breast masses.