自动乳腺全容积成像技术及常规超声检查鉴别诊断乳腺影像报告和数据系统4类病灶良恶性的价值比较  

Comparative study between automated breast volume scanner and conventional ultrasound in differentiation of benign and malignant breast imaging reporting and data system 4 breast lesions

作　　者：朱罗茜[1] 包凌云[1] 朱庆庆[1] 谭艳娟[1] Zhu Luoxi Bao Lingyun Zhu qingqing Tan Yanjuan.(Department of Ultrasound, the First People＇s Hospital of Hangzhou, Hangzhou 310006, China)

机构地区：[1]杭州市第一人民医院超声科,310006

出　　处：《中华医学超声杂志（电子版）》2016年第12期931-935,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：杭州市卫生科技计划项目(2013A16)

摘　　要：目的比较自动乳腺全容积成像(ABVS)及常规超声检查鉴别诊断对乳腺影像学报告及数据系统(BI-RADS)4类病灶良恶性的价值。方法选择2014年1至12月杭州市第一人民医院收治的经手术或穿刺活检病理证实的乳腺疾病患者217例共239个病灶。入选病灶常规超声检查和ABVS检查均评为BI-RADS 4类。绘制常规超声检查、ABVS鉴别诊断BI-RADS 4类乳腺病灶良恶性的操作者工作特征(ROC)曲线,计算常规超声检查、ABVS鉴别诊断BI-RADS 4类乳腺病灶良恶性的敏感度、特异度、准确性及曲线下面积。结果 217例患者239个病灶中良性病灶154个,交界性病灶2个,恶性病灶83个;常规超声检查鉴别诊断BI-RADS 4类乳腺病灶良恶性的敏感度、特异度、准确性和曲线下面积分别为91.80%、80.20%、84.10%和0.833;ABVS鉴别诊断BI-RADS 4类乳腺病灶良恶性的敏感度、特异度、准确性和曲线下面积分别为96.10%、84.30%、89.30%和0.952。结论 ABVS较常规超声检查能够提高鉴别诊断BI-RADS 4类乳腺病灶良恶性的敏感度、特异度、准确性,能更好检出早期或者不典型乳腺癌,可作为一种无创和可靠的方法对常规超声检查做一补充。Objective To evaluate the value of automated breast volume scanner （ABVS） and conventional ultrasound in differentiation of benign and malignant breast imaging reporting and data system （BI-RADS） 4 breast lesions. Methods Totally 239 breast lesions from 217 patients, with diagnosing of BI-RADS 4 by conventional ultrasound and automatically breast volume imaging, were analyzed retrospectively, using postoperative pathology as golden standard. The sensitivity, specificity, accuracy and area under the curve of ABVS and conventional ultrasound were calculated separately. Results There were 154 benign breast lesions, 83 malignant lesions and 2 borderline lesions. The statistical analysis results of ABVS and conventional ultrasound were 96.10% and 91.80% in sensitivity, 84.30% and 80.20% in specificity, 89.30% and 84.10% in accuracy, and 0.952 and 0.833 in area under the curve. Therefore, ABVS was superior to the conventional ultrasound. Conclusion Compared with conventional ultrasound, ABVS could improve the diagnostic efficacy for BI-RADS 4 breast lesions in the aspects of sensitivity, specificity, accuracy, which was useful in detection of small and atypical breast cancer and could be used as a noninvasive and reliable complement for conventional ultrasound.

关 键 词：自动乳腺全容积成像 常规超声检查 乳腺影像报告和数据系统 乳腺疾病 

分 类 号：R445.1[医药卫生—影像医学与核医学] R655.8[医药卫生—诊断学] R737.9[医药卫生—临床医学]