钼靶X线与超声对乳腺影像报告与数据系统(BI-RADS)Ⅲ～Ⅳ级乳腺病变的诊断价值  

Comparative analysis of BI-RADS Ⅲ-Ⅳ lesions imaging by X-ray mammography and ultrasound

作　　者：雷瑞美 叶晓青 董旭霞[2] 童嘉毅[3] 

机构地区：[1]浙江省丽水市妇幼保健院放射科,浙江丽水323000 [2]浙江省绍兴市中医院放射科,浙江绍兴312000 [3]东南大学,江苏南京210018

出　　处：《中国现代医生》2013年第24期81-83,F0003,共4页China Modern Doctor

基　　金：高等学校博士学科点专项科研基金(20090092120059)

摘　　要：目的探讨钼靶X线与超声对乳腺影像报告与数据系统(BI-RADS)Ⅲ～Ⅳ级乳腺病变的诊断价值。方法对我院2010年1月～2012年12月经术后病理证实的100例BI-RADSⅢ～Ⅳ级女性乳腺肿块患者的钼靶X线及超声检查的资料进行回顾性分析,总结两种方法在影像学诊断中的特点。结果 100例乳腺肿块患者120个病灶,74个为BI-RADSⅢ级,良性57个,占77.03%;恶性17个,占22.97%;46个为BI-RADS IV级,良性7个,占15.22%,恶性39个,占84.78%。钼靶X线图像以片状致密影、结节状影、肿块影、钙化影以及致密模糊结节影为主要的临床表现,其阳性诊断率为77.5%,正确率为78.3%,误诊率11.7%,漏诊率10.0%;而超声图像主要液性、混合性、实质性、边界清晰或不清等局限性病变为主,其阳性诊断率为91.7%,正确率为75.0%,误诊率14.2%,漏诊率10.8%。而超声和钼靶X线联合检查,阳性诊断率为95.8%,正确率92.5%,误诊率4.2%,漏诊率3.3%。两者联合检查的阳性率以及准确率均高于二者单独检查(P<0.05);且误诊率和漏诊率明显低于单独检查(P<0.05)。结论钼靶X线联合超声检查可以互补各自的缺点,大大提高BI-RADSⅢ～Ⅳ级乳腺疾病的检出率,提高阳性诊断率,从而避免因漏诊给患者带来不利的影响。Objective To investigate the application value of breast imaging reporting and data system（BI-RADS） Ⅲ-Ⅳ lesions by X-ray mammography and/or ultrasound. Methods 100 patients in our hospital from January 2010 to De- cember 2012 with BI-RADS Ⅲ-Ⅳ lesions confirmed by pathological diagnosis were enrolled. All of them underwent clinical examination, mammography and ultrasound, summarized radiographic features of mammography and ultra- sound. Results 100 patients had 120 lesions. 74 BI-RADS Ⅲ, 57 benign, accounting for 77.03%; vicious 17, account- ing for 22.97%; 46 BI-RADS Ⅳ ,7 benign, accounting for 15.22%, malignant 39, accounting for 84.78%. Molybde- num target X-ray image performance to flake opacities, nodules, lumps shadow, calcification and dense fuzzy nodules, positive diagnosis was 77.5% ,accuracy was 78.3%, misdiagnosis rate was 11.7% ,the rate of misdiagnosis was 10.0%; ultrasound images mainly restricted lesions, fluid, mixed, materiality, the boundary clear or unclear, the positive diag- nosis was 91.7%, the correct rate of 75.0% ,the rate of misdiagnosis 14.2%, misdiagnosis rate of 10.8%. Ultrasound and mammography X-ray of the Joint Inspection positive diagnosis was 95.8%,accuracy rate was 92.5%, the misdiag- nosis rate of 4.2%, 3.3% of the rate of misdiagnosis. Joint Inspection of both positive rate and the accuracy rate is higher than the two separate checks,P 〈 0.05; misdiagnosis and missed diagnosis rate was significantly lower than the two separate checks （P 〈 0.05）. Conclusion It is demonstrated that the mechanism of mammography and ultrasound imaging are different.Combination of the two approaches could improve the BI - RADS Ⅲ-Ⅳ detection rate and ac- curacy of differential diagnosis between benign and malignant lesion.

关 键 词：乳腺肿瘤 超声检查 钼靶X线检查 

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