BI-RADS诊断标准与UE结合对乳腺肿物诊断价值的探讨  

Combination of BI-RADS and Ultrasonic elastagraphy in Differentiation of Breast Lesions

作　　者：智慧[1] 肖晓云[1] 杨海云[1] 吴欢[1] 罗葆明[1] 

机构地区：[1]中山大学附属第二医院超声科,广州市510120

出　　处：《中国超声医学杂志》2011年第4期310-312,共3页Chinese Journal of Ultrasound in Medicine

基　　金：广东省医学科研项目(No.A2007192)

摘　　要：目的通过比较乳腺影像学报告及数据系统(BI-RADS)诊断标准与超声弹性成像(UE)改良5分法判断乳腺肿物良恶性的诊断价值,期望为乳腺超声检查的诊断思路提供依据。方法对手术病理证实的629例患者共732个病灶(良性508个,恶性224个)行常规超声检查按照BI-RADS评分标准进行评分,再行UE检查以改良5分法为标准进行评分。以病理诊断为金标准,构建受试者应用曲线(ROC),比较2种方法的诊断效率。结果 BI-RADS标准ROC曲线下面积(AUC)0.882,UE改良5分法AUC 0.927,二者之间的差异有统计学意义(P<0.05)。2种方法结合AUC 0.977,诊断价值高于单一方法 (P<0.05)。UE对乳腺肿物诊断的特异性、准确性要高于BI-RADS诊断标准(P<0.05)。结论 BI-RADS标准与UE结合可以提高诊断准确性,对于UE发现的质地较硬的病灶要高度警惕是恶性可能。Objective To provide the proof for breast lesion sonographic diagnosis through comparing BI-RADS and ultrasonic elastography（UE）improved-5-point standard. Methods 629 patients with 732 lesions（508 benign, 224 malignant） were included in the study. The lesions were examined by ultrasound and the strain images were obtnined by UE. The lesions were scored with BI RADS and improved-5-scoring system respectively. The pathologic diagnosis was as golden standard. The diagnostic performance of the 2 methods was evaluated with receiver operating characteristic curve（ROC）. Results The areas under the curve（AUC）of the 2 methods were BI-RADS 0. 882, UE 0. 927. After ROC comparing,the diagnostic performance of UE was better than that of BI-RADS（P〈0.05）. The AUC of the eombina tion of the 2 methods was 0. 977. The diagnostic performance of the combination was better than any of the 2 meth ods. The specificity and accuracy of UE were better than those of BI RADS（P〈0.05）. Conclusions The combination of BI-RADS and UE could improve the differentiation of breast lesions. The hard lesion evaluated with UE should be paid more attention.

关 键 词：BI—RADS 弹性成像 乳腺肿物 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]