乳腺超声影像报告数据系统在乳腺病灶诊治中的应用价值  

Application Value of Breast Imaging Reporting and Data System in Diagnosis and Excision of Breast Lesion

作　　者：马慧娟[1] 冷振鹏[1] 王萍[1] 卢金生[1] 康骅 

机构地区：[1]首都医科大学宣武医院超声诊断科,北京市100053 [2]普通外科

出　　处：《中国超声医学杂志》2013年第11期971-974,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨乳腺超声影像报告数据系统(BI-RADS)对乳腺病灶诊断和治疗的应用价值。方法 262例超声评价为BI-RADS 3、4、5级的乳腺病变患者,3级及部分4a级行Mammotome切除活检(US-MEB),其余行超声引导下穿刺活检,分析BI-RADS分级的敏感度、特异度、准确度、阳性预测值(PPV)和阴性预测值(NPV),以及各分级的PPV。结果病理结果:良性病变166例,恶性病变96例。BI-RADS分级的敏感度、特异度、准确度、PPV及NPV分别为91.7%、71.7%、79.0%、65.2%、93.7%。分为3、4a、4b、4c级和5级的PPV值分别为1.4%、12.7%、39.2%、70.2%、94.6%,随着分类级别的增高,PPV逐渐增高,各级别之间比较均有统计学差异(P<0.05)。结论 BI-RADS分级对乳腺病灶的诊治具有重要的指导意义。3级病灶可以短期随访,或应用US-MEB术治疗;4a级病灶恶性程度小,一部分可行US-MEB术达到诊断和治疗的目的;4b、4c、5级病灶应穿刺活检。Objective To evaluate the application value of breast imaging reporting and data system （ BI-RADS ） in diagnosis and excision of breast lesion. Methods 262 cases of breast lesions were diagnosed as BI-RADS categories 3, 4, 5 by ultrasound. All of breast lesions in category 3 and a part of breast lesions in category 4a received ultra- sound-guided mammotome excisional biopsy （US-MEB）. other lesions received ultrasound-guided breast biopsy. The sensitivity, specificity, accuracy, positive predictive value （PPV） and negative predictive value （NPV） for BI-RADS classification of benign and malignant breast lesions were calculated. PPV was calculated for each BI-RADS category. Results 166 were confirmed benign and 96 were confirmed malignant by histopathology. The sensitivity, specificity, accuracy, PPV and NPV of BI-RADS classification were 91.7%, 71.7%, 79.0%, 65.2% and 93.7%. PPV of BI- RADS category 3, 4a, 4b, 4c and 5 were 1.4%, 12.7%, 39.2%, 70.2% and 94.6% respectively, it had statistically significant difference between the categories （P^0.05）. Conclusions BI-RADS classification has important guiding value in diagnosis and excision of breast lesions. The patients in category 3 should be associated with short-term fol- low-up or US-MEB could be performed. The malignant possibility of breast lesions in BI-RADS category 4a is very small, so it is feasible to perform US-MEB for most of breast lesions in BI-RADS category 4a. And it is necessary to perform biopsy for BI-RADS category 4b, 4c and 5.

关 键 词：乳腺超声影像报告数据系统 超声检查 麦默通 穿刺活检 

分 类 号：R445.1[医药卫生—影像医学与核医学]