乳腺影像报告与数据系统对临床触诊阴性乳腺病灶分类的价值  

Nonpalpable breast lesions categorization by breast imaging reporting and data system (BI-RADS)

作　　者：王仲照[1] 张保宁[1] 李静[2] 蒋力明[2] 

机构地区：[1]中国医学科学院肿瘤医院乳腺疾病诊治中心,北京100021 [2]中国医学科学院肿瘤医院影像科,北京100021

出　　处：《中华普通外科杂志》2005年第11期707-709,共3页Chinese Journal of General Surgery

基　　金：国家"十五"科技攻关项目(2001BA703B20)

摘　　要：目的探讨乳腺影像报告与数据系统(breast imaging reporting and data system,BI-RADS)对于临床触诊阴性乳腺病灶分类的意义及指导乳腺病灶活检的价值。方法由X线摄影发现的触诊阴性乳腺病灶162个,按照美国放射学会制定的第四版BI-RADS对其分类,所有病灶均采用金属线定位活检技术获得组织学诊断。结果全组162个触诊阴性病灶中,确认乳腺癌46个,阳性预测值为28.4%。按照BI-RADS分类,2类病灶11例,其中癌0例;3类病灶55例,癌2例;4类病灶77例,癌29例;5类病灶19例,癌15例;BI-RADS2-5类病灶癌的阳性预测值分别为0%,3.6%,37.7%与78.9%。结论BI-RADS分类大大提高了触诊阴性乳腺病灶影像诊断的特异性,可用于指导活检指征的选择,建议对BI-RADS4类与5类病灶进行活检,以提高触诊阴性乳腺病灶活检的阳性率。Objective To evaluate breast imaging reporting and data system （BI-RADS） in categorization and biopsy of nonpalpable breast lesions （NPBLs）, Methods One hundred and sixty-two NPBLs from 144 female patients detected by mammography were retrospectively categorized according to BI- RADS. All the lesions finally got histopathological diagnosis by wire-localization biopsy. Results There were 46 malignant lesions, with the positive predictive value for cancer of 28.4% （46/162）. The cases of BI-RADS 2-5 lesions were 11, 55, 77, and 19 after categorization according to the BI-RADS, and the positive predictive value of each category for cancer was 0% （0/11 ） ,3.6% （2/55）, 37.7% （29/77）, 78.9% （15/19） respectively. Conclusion BI-RADS categorization improves the diagnostic specificity of nonpalpable breast lesions and helps decision-making for biopsy. It is suggested that NPBLs on category of BI-RADS 4 or 5 should undergo biopsy.

关 键 词：乳腺肿瘤 乳房X线摄影术 触诊 活组织检查 

分 类 号：R655.8[医药卫生—外科学]