Fischer评分结合MR影像报告数据系统鉴别乳腺良恶性病变的价值  

Value of combing the Fischer scoring system with MR breast imaging reporting and data system in differentiation between benign and malignant breast lesions

作　　者：刘伟 叶春涛[1] 林光武[1] 李蔚萍[1] 嵇鸣[1] 

机构地区：[1]复旦大学附属华东医院放射科MR室,上海200040

出　　处：《实用放射学杂志》2012年第9期1366-1370,共5页Journal of Practical Radiology

摘　　要：目的 探讨Fischer评分结合MR影像报告数据系统（MR breast imaging reporting and data system,MRBIRADS）在鉴别乳腺良恶性病变中的临床应用价值.方法 65例乳腺病例行3.0T MR检查,所有病例经穿刺活检或手术病理证实.扫描序列包括平扫T1WI、T2WI、StirT2WI、Flash3D动态增强扫描.结合Fischer评分与MR影像报告数据系统对病变进行评估、分级,其诊断良恶性结果与病理对照.计算MRBIRADS诊断的敏感性、特异性、准确率、阳性预测值、阴性预测值.结果 病理结果显示良性病变30例,恶性病变35例.良性病变评分BIRADS Ⅰ级2例,Ⅱ级3例,Ⅲ级19例,Ⅳ级4例,Ⅴ级2例;恶性病变Ⅰ级1例,Ⅱ级1例,Ⅲ级3例,Ⅳ级 10例,Ⅴ级20例.诊断敏感性、特异性、准确率、阳性预测值、阴性预测值分别为85.7%、80%、83.1%、83.3%、82.8%.结论 Fischer评分结合MRBIRADS将乳腺病变的形态学与动态增强表现有机地结合,为乳腺癌的诊断制定规范的诊断步骤和标准,在乳腺良恶性病变的鉴别诊断中具有重要的临床应用价值.Objective To investigate the clinical applied value of combing the Fischer scoring system with MR breast imaging re- porting and data system（MR-BI-RADS） in differentiation between benign and malignant breast lesions. Methods 65 cases with be- nign（30） and malignant{35） breast Iesions pathologically proven by operation or biopsy underwent MR imaging examination at 3.0T MR scanner. The scanning sequences included T2 WI, T2WI, stir-T2 WI and Flash 319 dynamic contrast-enhancement （DCE}. The morphological feature and DCE manifestations of the lesions were analyzed and tbe evaluating scores were calculated according to the criteria of combing the Fischer scoring system with MR-BI-RADS. The diagnostic result of differentiation between benign and malignant breast lesions was compared with pathoIogy. The sensitivity, specificity, diagnostic accuracy, postitive predictive value and negative predictive value of MR-BI-RADS were calculated, respectively. Results In 30 benign lesions, the lesions were graded as BI-RADS I in 2,II in 3, III in 19, IV in 4 and V in 2 lesions ,while in 35 malignant lesions, the tumors were characterized as BI-RADS I in l, II in 1, III in 3, IV in 10 and V in 20 lesions. The sensitivity,specificity,diagnostic accuracy,pnsitive predictive value and negative predictive value of MR-BI-RADS were 85.7 %, 80 % , 83. 1%,83.3% and 8.9. 8%. Conclosion The Fischer scoring system combined with MR-BI-RADS is valuable in differentiating the malignant lesions from the benign, which can provide an objective standard and criteria in diagnosis of breast cancer.

关 键 词：乳腺 磁共振成像 乳腺影像报告数据系统 乳腺肿瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]