对比分析自动乳腺容积成像技术与常规手持超声对乳腺BI-RADS3~5类病变的评估价值  

Value of automated breast volume scanner versus handheld ultrasound in evaluating Breast Imaging Reporting and Data System 3～5 breast lesions:a comparative analysis

作　　者：袁红梅[1] 苟凌云[1] 唐盈[1] 顾鹏[1] 岳文胜[1] 谢少利 赵小波[2] 李滟岭 YUAN Hongmei;GOU Linyun;TANG Yin;GU Peng;YUE Wensheng;XIE Shaoli;ZHAO Xiaobo;LI Yanlin(Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, Sichuan Key Laboratory of Medical Imaging, Nanchong 637000, Sichuan;Key Laboratory of Medical Imaging, Sichuan Province; Department of Alpha - Lactic Surgery, Affiliated Hospital of North Sichuan Medical College; Nanchong 637000, Sichuan)

机构地区：[1]四川省医学影像重点实验室川北医学院附属医院超声科,四川南充637000 [2]川北医学院附属医院甲乳外科,四川南充637000

出　　处：《西南医科大学学报》2018年第6期525-530,共6页Journal of Southwest Medical University

基　　金：南充市级应用技术与开发项目(16YFZJ0058;15A0007)

摘　　要：目的:探讨自动乳腺容积成像技术(automated breast volume scanner, ABVS)与常规手持超声(handheld ultrasound,HHUS)对乳腺BI-RADS 3～5类病变的分类评估价值。方法:回顾性分析我院2016年10月至2017年6月期间对109个乳腺病灶进行自动乳腺容积成像技术与常规手持超声的影像资料,基于乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)分别对病变进行分类评定,以病理诊断为标准,将BI-RADS分类为3、4A、4B、4C、5类的良性病变分别评为5、4、3、2、1分。将BI-RADS分类为3、4A、4B、4C、5类的恶性病变分别评为1、2、3、4、5分。结果:92例患者109个乳腺病灶,80个恶性病灶,29个良性病灶。29个良性病灶包括纤维腺瘤12例、腺病瘤7例、复杂性囊肿3例、浆细胞性乳腺炎2例、肉芽肿性乳腺炎1例、导管内乳头状瘤1例、良性叶状肿瘤1例、小叶增生性腺病并放射状瘢痕1例、硬化性腺病1例;ABVS评价为5、4、3、2、1分的分别为24、1、2、2、0个,HHUS评价为5、4、3、2、1分的分别为19、8、1、1、0个。80个恶性病变包括导管内原位癌2例、非浸润性癌5例、早期浸润癌10例、浸润性非特殊癌39例、浸润性特殊癌24例;ABVS评价为5、4、3、2、1分的分别为17、35、22、6、0个,HHUS评价为5、4、3、2、1分的分别为12、25、31、10、2个。将ABVS与HHUS对乳腺病变的BI-RADS分类评分进行对比分析,Z=-3.069,P=0.002,差异有统计学意义。结论:ABVS能准确的对乳腺BI-RADS 3～5类病变进行分类评估,且ABVS较HHUS具有整体性强、可重复率高、操作者依赖性小、不易漏诊等优点,因而可以作为一种乳腺BI-RADS分类评估的常规检查方法。Objective:To investigate the value of automated breast volume scanner(ABVS)versus handheld ultrasound(HHUS)in evaluating Breast Imaging Reporting and Data System(BI-RADS)3~5breast lesions.Methods:A retrospective analysis was performed for the imaging data of109breast lesions evaluated by ABVS and HHUS in our hospital from October2016to June2017,and the lesions were classified and evaluated according to BI-RADS.With pathological diagnosis as the standard,BI-RADS3,4A,4B,4C,and5benign lesions were evaluated as5,4,3,2and1point,respectively,and BI-RADS3,4A,4B,4C,and5malignant lesions were evaluated as1,2,3,4,and5points,respectively.Results:There were109breast lesions in92patients,including80malignant lesions and29benign lesions.Among the 29 benign lesions,there were12lesions of fibroadenoma,7lesions of adenoma,3lesions of complex cyst,2lesions of plasma cell mastitis,and1lesion each of granulomatous mastitis,intraductal papilloma,benign lobular tumor,lobular hyperplastic adenopathy with radial scar,and sclerosing adenosis;24,1,2,2,and0lesions were evaluated as5,4,3,2,and1points,respectively,by ABVS,while19,8,1,1,and0lesions were evaluated as5,4,3,2,and1points,respectively,by HHUS.Among the80malignant lesions,there were2lesions of ductal carcinoma in situ,5lesions of noninvasive carcinoma,10lesions of early invasive carcinoma,39lesions of invasive non-special carcinoma,and24lesions of invasive special carcinoma;17,35,22,6,and0lesions were evaluated as5,4,3,2,and1points,respectively,by ABVS,while12,25,31,10,and2lesions were evaluated as5,4,3,2,and1points,respectively,by HHUS.There was a significant difference in BI-RADS classification and scores between ABVS and HHUS(Z=-3.069,P=0.002).Conclusion:ABVS can accurately classify and evaluate BI-RADS3~5breast lesions,and compared with HHUS,ABVS has the advantages of high integrity,high repeatability,a low level of dependence on operator,and few missed diagnoses.Therefore,it can be used as a routine method for BI-RADS classification and evaluation.

关 键 词：乳腺肿瘤 自动乳腺容积成像技术 常规手持超声 乳腺影像报告和数据系统 

分 类 号：R445.1[医药卫生—影像医学与核医学]