乳腺影像报告和数据系统超声标准化描述术语对鉴别诊断乳腺良恶性肿瘤的价值  

Value of BI-RADS standardized description of ultrasound in differential diagnosis of benign and malignant breast neoplasms

作　　者：陈铃[1] 张建兴[1] 石小红[1] 孙鹏涛[1] 杨丽丽[1] 

机构地区：[1]广东省中医院超声诊断科,广东广州510120

出　　处：《中国医学影像技术》2013年第11期1746-1750,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨超声乳腺影像报告和数据系统(BI-RADS)标准化描述术语在乳腺良恶性肿瘤鉴别诊断中的价值。方法选择因乳腺肿瘤接受手术治疗的458例患者(677个肿瘤,恶性150个,良性527个),采用BI-RADS超声规范化术语描述乳腺肿块的形态学信息,并与病理结果相对照。结果良恶性乳腺瘤的形态、边界、边缘、后方回声、生长方式、钙化、最大直径、周围组织改变的差异有统计学意义(P均<0.01)。超声BI-RADS标准化描述术语中,形态不规则预测乳腺恶性肿瘤的敏感度和特异度分别约86.00%和90.32%;高回声晕的特异度为100%。病理结果与BI-RADS 3类和5类一致性满意(Kappa值=0.70、0.74),与4a、4c类的一致性较差(Kappa值=0.35、0.01),与4b类结果不一致(Kappa值=-0.01)。结论形态不规则、高回声晕、边缘不光整、垂直性生长、后方回声衰减或混合性改变、肿瘤内微钙化、周围组织改变可作为乳腺恶性肿瘤的征象,其中形态不规则、边缘毛刺、边缘成角、肿瘤内微钙化可作为预测恶性肿瘤的主要指标。Objective To explore the value of standardized description in breast imaging reporting and data system （BI- RADS） classification for ultrasound examination in differential diagnosis of benign and malignant breast neoplasms. Methods Totally 677 breast lesions （150 malignant, 527 benign lesions） in 458 patients who underwent surgical exploration were enrolled. The standardized description in BI-RADS of breast lesions were obtained and compared with pathological results. Results The morphology, borders, edgs, posterior echo, growth pattern, calcification, maximum diameter, surrounding tissue changes of benign and malignant breast tumor had statistical significance （all P〈0.01）. The sensitivity and specificity of irregular shape in ultrasound BI-RADS standardized description was 86.00 % and 90.32 %, respectively. The specificity of peripheral hyperechoic was 100%. Compared with pathological results, the consistency was satisfied for BIRADS 3 and 5 lesions （Kappa value：0.70, 0.74）, but was poor for BI-RADS 4a and 4c lesions （Kappa value=0.35, 0.01）, while disagreement for BI-RADS 4b lesions （Kappa value=-0.01）. Conclusion Irregular shape, peripheral hyperechoie, margin not circumscribed, vertical orientation, posterior attenuation or combined pattern, calcification and chan- ges in surrounding tissue can be regarded as signs of malignant breast lesions. Irregular shape, spicular margin, angular margin and calcification within tumor are major predictor of malignant tumors, and the rest of the changes are secondary indicators.

关 键 词：乳腺影像报告和数据系统 超声检查 乳腺肿瘤 诊断显像 

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