乳腺肿块病理类型与超声BI-RADS 3、4、5级的对照分析

Comparative analysis of pathological types of breast mass and ultrasonic BI-RADS 3,4,5

目的研究超声乳腺影像报告和数据系统(BI-RADS)3、4、5级在不同病理类型乳腺肿块诊断中的应用价值。方法选取我院2012年1月至2015年10月乳腺超声诊断为BI-RADS 3、4、5级的患者237例,病灶265个,与病理类型进行对照分析。结果超声BI-RADS 3、4、5级对乳腺恶性肿块诊断的灵敏度、特异度、阳性预测值、阴性预测值分别为95.1%(77/81)、78.8%(145/184)、66.4%(77/116)、97.3%(145/149)。乳腺肿块超声BI-RADS3、4、5级中恶性肿瘤的百分率分别为2.7%(4/149)、48.0%(36/75)、100.0%(41/41)。良性肿块中乳腺炎性病变、腺病瘤化、腺病伴囊肿、导管内乳头状瘤、腺病伴大汗腺化生的灵敏度较低[0(0/7)~50.0%(2/4)]。恶性肿块中叶状肿瘤灵敏度较低[75.0%(3/4)]。将乳腺良性肿块分为不合并腺病组(141例)与合并腺病组(43例),进行超声BI-RADS分级,两组的分级结果比较差异无统计学意义(P>0.05)。结论超声BI-RADS分级可对乳腺肿块进行较准确的评估,不同病理类型的乳腺肿块BI-RADS分级的灵敏度不同。

Objective To evaluate the application value of ultrasound breast imaging reporting and data system(BI-RADS) 3,4,5 in the diagnosis of different pathological types of breast masses. Methods The clinical data of 237 patients(265 breast lesions) who were diagnosed as BI-RADS 3, 4, 5 by ultrasonography in our hospital from January2012 to October 2015 were reviewed and compared with the pathological results. Results The sensitivity, specificity,positive predictive value and negative predictive value of BI-RADS 3, 4, 5 on breast malignant tumor were 95.1%(77/81), 78.8%(145/184), 66.4%(77/116), 97.3%(145/149), respectively. The percentage of malignant tumor in BI-RADS3, 4, 5 was 2.7%(4/149), 48.0%(36/75) and 100.0%(41/41), respectively. The sensitivity of benign lesions such as mastitis lesions, adenosis tumor, adenosis with cyst, intraductal papilloma, adenosis with apocrine metaplasia was relatively low [0(0/7)~50.0%(2/4)]. The sensitivity of phyllodes tumor was 75.0%(3/4). The ultrasonic BI-RADS grading results showed no statistically significant difference between the patients of benign breast masses without adenosis(141 cases)and the patients with adenosis(43 cases), P>0.05. Conclusion Ultrasonic BI-RADS can evaluate breast mass accurately, and different pathological types of breast masses have different sensitivity by BI-RADS.