超声弹性成像与钼靶对乳腺肿块BI-RADS分类诊断价值

Value of ultrasound elasticity imaging and mammography BI-RADS to the classification diagnosis of breast lumps

目的探讨超声弹性成像与钼靶对乳腺肿块BI-RADS分类诊断价值的准确性。方法 112例乳腺肿块(116个病灶),均行超声弹性成像与X线钼靶BI-RADS分类诊断,将2类、3类和4a类归为良性,4b、4c类和5类归为恶性;比较二者对乳腺肿块BI-RADS分类诊断的灵敏度、特异度、准确率、阳性预测值、阴性预测值、阳性似然比、阴性似然比,以及对不同直径乳腺肿块的诊断价值。结果组织病理检查结果显示,恶性病灶45个,良性病灶71个;超声弹性成像BI-RADS分类诊断乳腺肿块的灵敏度(84.44%)、特异度(90.14%)、准确性(75.00%)、阳性预测值(84.44%)、阴性预测值(90.14%)、阳性似然比(8.57)、阴性似然比(0.17)与钼靶BI-RADS分类诊断(82.22%、87.32%、70.00%、80.43%、88.57%、6.49、0.20)比较差异无统计学意义(P>0.05);X线钼靶BI-RADS分类诊断直径<10 mm肿块的准确性(68.00%)高于超声弹性成像BI-RADS分类诊断(48.00%),诊断直径10~20mm肿块的准确性(67.00%)与超声弹性成像BI-RADS分类诊断(77.00%)比较差异无统计学意义(P>0.05),诊断直径>20mm肿块的准确性(73.00%)低于超声弹性成像BI-RADS分类诊断(87.00%)(P<0.05)。结论超声弹性成像与X线钼靶对乳腺肿块BI-RADS分类均有较高诊断价值,二者对不同直径乳腺肿块的诊断各具优势。

Objective To explore the accuracy of ultrasound elasticity imaging versus mammography BI-RADS in the classification diagnosis of breast lumps.Methods A total of 112 patients with breast lumps(116lesions)underwent ultrasound elasticity imaging and X-ray mammography BI-RADS classification,in which lumps in class 2,3and 4awere benign tumors,and in class 4b,4cand 5 were malignant tumors.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio,as well as the value to the diagnosis of breast lumps in different diameter were compared between ultrasound elasticity imaging and mammography BI-RADS.Results The histopathologic results showed 45 malignant lesions and 71 benign lesions.The sensitivity of ultrasound elasticity imaging BI-RADS classification for the diagnosis of breast lumps was 84.44%,specificity was 90.14%,accuracy was 75.00%,positive predictive value was 84.44%,negative predictive value was90.14%,positive likelihood ratio was 8.57,and negative likelihood ratio was 0.17,showing no significant differences in comparison with those of mammography BI-RADS classification(82.22%,87.32%,70.00%,80.43%,88.57%,6.49,0.20)(P>0.05).The accuracy of mammography BI-RADS was significantly higher for the diagnosis of lesions<10mm in diameter than that of mammography BI-RADS(68.00%vs 48.00%)(P<0.05),showed no significant differences for the diagnosis of lesions 10 to 20mm in diameter(67.00% vs 77.00%)(P>0.05),and was significantly lower for the diagnosis of lesion >20 mm in diameter(73.00% vs 87.00%)(P<0.05).Conclusion Both ultrasound elasticity imaging and mammography BI-RADS have a high diagnostic value to breast lumps classification,with their own advantages in the diagnosis of breast lumps in different diameter.