Fischer’s评分结合MR影像报告数据系统在乳腺病灶定性中的应用价值  

Fischer's Scoring System Combined with MR Breast Imaging Reporting and Data System in Diagnosis of Breast Lesions

作　　者：张丽[1] 韩立新[1] 曹惠霞[1] 杜渭清[1] 莫树群[1] 王俊[1] 

机构地区：[1]广州军区广州总医院MR室,510010

出　　处：《临床放射学杂志》2013年第10期1432-1435,共4页Journal of Clinical Radiology

基　　金：广东省自然科学基金资助项目(编号:10151001002000006)

摘　　要：目的探讨乳腺磁共振Fischer’s评分结合MR影像报告数据系统（BI—RADS）鉴别乳腺病灶良恶性的临床应用价值。方法对我院乳腺外科触诊可疑乳腺肿物，乳腺钼靶或乳腺B超检查发现病变但不能明确诊断的患者行乳腺MRI检查。着重对MRI发现病变的4J4例女性患者进行分析，年龄25～7l岁，平均（45．1l±11．04）岁。按照2003年美国放射学会提出的针对乳腺MRBI—RADS对所发现的乳腺病灶进行分析，将病灶分为点状病灶、肿块及非肿块样强化病灶3大类。同时结合Fischer’S评分与MRBI—RADS对病变进行评估、分级，并与术后病理结果对照，计算Fischer’S评分与BI—RADS系统诊断病变的准确性。结果44例共发现47个病灶，乳腺MRI表现为点状强化病灶2个，肿块样强化病灶39个，非肿块样强化病灶6个。病理证实的良性病灶25个，恶性病灶22个。Fischer’S评分结合BI—RADS系统诊断的准确性为87％[（19＋22）／47]，敏感性为76％（19／25），特异性为100％（22／22），误诊率即假阳性率0％，漏诊率34％。结论Fischer’s评分结合BI—RADS系统将乳腺病变的形态学表现与动态增强表现有机结合，为乳腺癌的诊断规范了诊断步骤及标准，有助于乳腺病变的定性诊断，尤其对于MRI表现为肿块样病变良恶性的鉴别诊断准确性高于非肿块样病变。Objective To investigate the value of Fischer＇ s scoring system combined with MR breast imaging reporting and data system （ MR BI RADS ） in differential diagnosis of breast lesions. Methods Forty four female patients （ age range 25 - 71years, mean age of 45.11 ± 11.04years） with breast lesions underwent MRI examination. According to MR BI RADS （2003 by ACR） , the breast lesions were divided into three main categories： focus or foci, masses and non mass like enhancement. We analyzed these lesions by Fischer＇ s scoring system and then compared the results with pathology. The sensitivity,specificity and accuracy of the Fischer＇ s scoring system combined with MR BI RADS in the diagnosis of breast lesions were calculated. Results 47 lesions were found in 44 patients. There were 2 foci, 39 masses and 6 non- mass like enhancements, of which histopathology proven 25 benign and 22 malignant. The correct rate, sensitivity, speci- ficity of Fischer＇ s scoring system and BI RADS was 87% [ （19 ± 22）/471, 76% （19/25） and 100% （22/22） respective- ly. The false positive rate and false negative rate were 0% and 34%. Conclusion Fischer＇ s scoring system combined with MR BI RADS is helpful for distinguishing benign from malignant breast mass lesions, which can provide an objective standard and criteria in diagnosis of breast cancer.

关 键 词：Fischer’s评分系统 肿块 非肿块样强化 乳腺 

分 类 号：R655.8[医药卫生—外科学]