2013版超声BI-RADS分类对乳腺3-5类病灶的诊断准确性评估  

Assessment of Diagnostic Accuracy of the 2013 Edition of BI-RADS Ultrasound Lexicon in Diagnosing Breast Categories 3 to 5 Lesions

作　　者：胡越[1] 杨雅平[1] 顾然[1] 申时雨 刘凤桃 王红莉[1] 梅静思 苏逢锡[1] 

机构地区：[1]中山大学孙逸仙纪念医院乳腺肿瘤中心,广东广州510120

出　　处：《中山大学学报（医学科学版）》2017年第4期618-621,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(81672619;81372817)

摘　　要：【目的】评估2013版乳腺影像报告及资料系统(BI-RADS)分类在临床诊断性超声检查中的准确性。【方法】回顾中山大学孙逸仙纪念医院2014年6月-2016年6月因临床症状至乳腺中心行乳腺超声检查的成年女性病例,筛选最终分类3-5类且接受活检有最终病理诊断者进行分析,计算各类的阳性预测值(PPV),与美国放射学院(ACR)所提供的参考范围进行比较分析。【结果】共有来自4428例女性病人的4 428个病灶纳入本研究。1198(27.1%)例被诊断为病理恶/交界性;余3230(72.9%)例被诊断为病理良性。各BI-RADS分类的PPV均在2013年ACR所推荐的参考范围内。恶性病灶中,随着BI-RADS分类的升高,腋窝淋巴结阳性的比例增加。病理学诊断为浸润性导管癌或浸润性小叶癌的病例,其在BI-RADS分类中的分布呈现出从3类到5类的渐增趋势。【结论】本研究表明,2013版超声BI-RADS分类在临床工作中有着良好的诊断效能,但仍需进一步的多中心研究来证实。[Objective ] The objective of this study was to evaluate the diagnostic accuracy of the 2013 edition of Breast Imaging Reporting and Data System （BI-RADS） ultrasound lexicon in diagnosing breast categories 3 - 5 lesions. [ Methods ] Using our breast ultrasound database from June 2014 to June 2016, we identified 4428 BI-RADS category 3 to 5 lesions with a known pathological diagnosis in 4 428 adult women. The positive predictive value （PPV） of each BI-RADS category was calculated based on the patholog- ical diagnoses and compared with the reference range provided by the American College of Radiology （ACR）. [ Results ] 4 428 lesions from 4428 patients were included in this study. The PPV of each BI-RADS category waswithin the reference range provided by the ACR in 2013. 1198 （27.1%） pathological malignant/borderline results were found in the 4 428 lesions, the other 3 230 （72.9%） lesions were diagnosed with benign results. Among the malignant/borderline lesions , the rate of lymph node metastasis gradually increased as the BI-RADS categories were upgraded. Malignant lesions with a diagnosis ofinvasive ductal carcinoma or invasive lobular carcinoma showed an increasing distribution trend from category 3 to 5. [ Conclusion ] The 2013 editionof BI-RADS ultrasound lexiconhas good diagnostic accuracy and efficiencyin clinical practice.

关 键 词：乳腺 超声 BI—RADS 阳性预测值 

分 类 号：R8[医药卫生—临床医学]