BI-RADS分级在男性乳房疾病超声检查中的应用  

The application of BI-RADS category of ultrasound in male breast disease

作　　者：施惠芬[1] 马艳[1] 顾俊毅[1] 卢海燕[1] 浦浩[1] 韩扬[2] 宋树良[1] 

机构地区：[1]同济大学附属东方医院超声科,上海200120 [2]同济大学附属东方医院病理科,上海200120

出　　处：《医学影像学杂志》2013年第3期412-415,共4页Journal of Medical Imaging

摘　　要：目的探讨BI-RADS分级在男性乳房疾病超声检查中的应用。方法资料来自我院2002年～2012年4月门诊及病房申请乳腺超声检查、并且有完整资料记录的508例男性患者,年龄1.7～94岁,平均(46.97±20.21)岁。在所有患者中,临床拟诊男性乳房肥大症214例,临床检查或患者自述乳房内块状物132例,乳房疼痛38例,乳房增大13例,乳腺炎5例,其他15例。仪器使用HDI 5000、Sequoia 512、Logiq E9等,线阵探头,频率5～15MHz。检查时注意双侧对比,发现异常回声时注意其形态、边缘、内部回声强弱及均匀性、有无异常血流显示、后方回声有无衰减或增强等特点,测量其大小;所有患者资料,包括图像均由图文工作站保留。乳腺病变分级采取双盲法由3位医生分别完成。如果患者图像资料不完整则结合患者超声检查描述资料进行分级。分级结果汇总取多数原则。获得分级结果后与临床诊断或/和手术、病理检查结果对照分析,观察不同病理改变的Bi-Rads分级。结果本组记录男性乳腺检查508例,占同期乳腺检查患者的0.93%(508/54852),男女患者比例1:106.98。其中,男性乳房肥大症307例(60.43%),乳房脂肪瘤22例(4.33%),乳腺癌11例(2.17%),乳腺纤维瘤6例(1.38%),乳腺淋巴瘤1例(0.20%),乳腺炎6例(1.18%),其他5例(0.98%)。余150例(29.52%)超声检查未显示明显异常回声。依据分级标准,Bi-Rads 0级109例(21.46%),Bi-Rads 1级348例(68.50%),Bi-Rads 2级33例(6.50%),Bi-Rads 3级4例(0.79%),Bi-Rads 4级7例(1.38%),Bi-Rads 5级7例(1.38%)。没有6级病例。结论男性乳房解剖特点与女性比较有明显的不同,内部的腺体也基本处于不发育状态;超声检查时由于缺乏正常腺体的对比,对于男性乳房疾病的检查和诊断与女性有明显的差别,对于男性乳房的Bi-Rads分级与女性也应有所区别。尤其是Bi-Rads 0级Bi-Rads 1级的患者,男性和女性的处理有明显的不同,分级标准有待于进一步探讨�Objective To explore the application of Breast Imaging Reporting and Data System （BI-RADS） in male breast disease in ultrasound. Methods All 508 cases were from our hospital inpatients or outpatients, aged from 1.7 years-old to 94 years-old （average 46.97±20.21 years-old）, which included gynecomastia in 214, local lesion suspected in 132, breast pain in 38, breast enlargement in 13 cases, mastitis in 5 and others in 15. All examinations were performed by HDI 5000, Sequoia 512, Logiq E9 with the linear-array probes of frequency 5 MHz to 15 MHz. The ultrasonic images obtained were stored in computer workstation and the abnormities, if occurrence, were paid special attention to displaying the size, morphology, edge, internal echo intensity and uniformity, abnormal blood flow, posterior echo attenuation or en- hanced, and other characteristics. BI-RADS category was completed respectively by three doctors with the double-blind method based on the ultrasonic images or recordings in ultrasonic report under the condition of deficience＇images. The result of each patient＇s category was confirmed from all or more of the doctor＇s and compared with the clinical diagnosis and / or surgery, pathological findings. Results 508 male patients were about 0.93%（508/54852） of breast ultrasound examinations and the ratio of male to female was 1 ： 106.98 during the same period. The final diagnosis involved male breast hypertrophy in 307 cases （60.43%）, breast lipoma in 22 cases （4. 33%）, breast cancer in 11 cases （2.17%）, breast fihroma in 6 cases （1.38%）, breast lymphoma in 1 case （0.20M）, mastitis in 6 cases （1.18%） and others in 5 cases（0.98 %）. The rest of 150 cases （29.52%） did not show significantly abnormality in ultrasound. According to the criterion of BI-RADS, 109 cases （21.46%） were affirmed of category 0, 348 cases （68. 50~） category 1, 33 cases （6.50%） category 2, 4 cases （0.79%） category 3, 7 cases （1. 38%） category 4 and 7 cases （1. 38%） category

关 键 词：男性乳腺疾病 超声检查 乳腺影像报告和数据系统 

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