乳腺影像报告和数据系统在诊断乳腺良恶性病变中的应用价值

Value of breast imaging reporting and data system in the diagnosis of benign and malignant breast lesions

目的探讨乳腺影像报告和数据系统(BI-RADS)应用于诊断乳腺良恶性病变中的价值。方法回顾性分析2020-01-01-2023-06-01济源市妇幼保健院107例在院手术切除乳腺肿瘤并做相应病理检查患者的临床资料,所有患者均接受超声检查,并利用BI-RADS对其进行良恶性鉴定,以手术病理细胞学检查结果为金标准,比较BI-RADS评分与金标准的诊断效能,根据BI-RADS评分情况,分析良恶性肿瘤的超声征象及血流特征。结果107例乳腺肿瘤患者中,手术病理检查检测出恶性36例(33.64%),良性71例(66.36%);BI-RADS评分检测出良性69例(64.48%),恶性38例(35.52%);107例乳腺病变中,BI-RADS评分诊断乳腺肿瘤患者的灵敏度、准确度、特异度分别为94.44%、94.39%、94.37%,与金标准一致性较好(Kappa值=0.876);良恶性病变的形态(χ^(2)=14.076,P<0.001)、纵横比(χ^(2)=37.905,P<0.001)、边缘(χ^(2)=34.845,P<0.001)、钙化情况(χ^(2)=21.953,P<0.001)、边界(χ^(2)=34.810,P<0.001)、后方回声(χ^(2)=22.178,P<0.001)、周围组织改变(χ^(2)=48.937,P<0.001)间比较差异有统计学意义;而血流特征(χ^(2)=0.787,P=0.375)、肿瘤内部回声改变(χ^(2)=1.848,P=0.605)间比较差异无统计学意义。结论BI-RADS系统可有效辨别乳腺良恶性病变的图像征象,提高恶性肿瘤检出率,具有较高诊断价值。

Objective To explore the value of ultrasound breast imaging reporting and data system(BI-RADS)in the diagnosis of benign and malignant breast lesions.Methods Retrospective analysis was conducted on clinical data from 107patients who underwent surgical resection of breast tumors and corresponding pathological examinations at Jiyuan Maternal and Child Health Hospital from January 1,2020to June 1,2023.All patients underwent ultrasound examination and BIRADS was used to identify the benign and malignant nature.The results of surgical pathological cytology examination were used as the gold standard to compare the diagnostic efficacy of BI-RADS score with the gold standard.Then,according to the BI-RADS score,the ultrasonic signs and blood flow characteristics of benign and malignant tumors were analyzed.Results Among 107patients with breast tumor,36(33.64%)were diagnosed as malignant and 71(66.36%)as benign through surgical pathology examination;The BI-RADS score detected 69cases of benign(64.48%)and 38cases of malignant(35.52%);Among 107cases of breast lesions,the sensitivity,accuracy,and specificity of BI-RADS score in diagnosing breast tumor patients were 94.44%,94.39%,and 94.37%,respectively,which were consistent with the gold standard(Kappa=0.876);There were statistically significant differences in morphology(χ^(2)=14.076,P<0.001),aspect ratio(χ^(2)=37.905,P<0.001),margin(χ^(2)=34.845,P<0.001),calcification(χ^(2)=21.953,P<0.001),boundary(χ^(2)=34.810,P<0.001),posterior echo(χ^(2)=22.178,P<0.001),and changes in surrounding tissue(χ^(2)=48.937,P<0.001)between benign and malignant lesions,but there was no statistically significant difference in blood flow characteristics(χ^(2)=0.787,P=0.375)and changes in internal echo(χ^(2)=1.848,P=0.605).Conclusion The BIRADS system can effectively distinguish the image signs of benign and malignant breast lesions,improve the detection rate of malignant tumors,and have high diagnostic value.