乳腺X线BI-RADS分类的临床应用价值  

The clinical diagnostic value of breast imaging reporting and data system in mammography

作　　者：雍千叶 刘万花[2] 叶媛媛[2] 彭程宇[2] YONG Qianye;LIU Wanhua;YE Yuanyuan;PENG Chengyu(Medical School,Southeast University,Nanjing 210009,China;Department of Radiology,Zhongda Hospital,Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学医学院,江苏南京210009 [2]东南大学附属中大医院放射科,江苏南京210009

出　　处：《东南大学学报（医学版）》2021年第3期385-389,共5页Journal of Southeast University(Medical Science Edition)

基　　金：东南大学附属中大医院横向科研项目(2018010011)。

摘　　要：目的:评价乳腺X线影像报告与数据系统(BI-RADS)的临床应用价值。方法:依据BI-RADS分类标准对911例乳腺病患者共1063个病灶进行分类,以病理结果为金标准,使用受试者工作特征(ROC)曲线分析计算BI-RADS分类对乳腺病灶及对不同表观类型病灶的诊断效能。结果:乳腺X线BI-RADS分类对乳腺病灶诊断的准确率为87.4%,敏感度为86.5%,特异度为88.5%,阳性预测值(PPV)为90.5%,阴性预测值(NPV)为83.9%,ROC曲线下面积(AUC)为0.924。乳腺X线BI-RADS分类对肿块型病灶和非肿块型病灶的AUC值分别为0.948、0.886(P<0.05);对大肿块(直径为>2 cm)和小肿块(直径≤2 cm)的AUC分别为0.955、0.929(P<0.05);对钙化、非对称、结构扭曲的AUC值分别为0.946、0.866、0.843(P<0.05)。结果显示BI-RADS 3、4A、4B、4C、5类病灶的恶性率分别为7.2%、25.2%、75.8%、96.9%、98.7%。结论:BI-RADS分类对乳腺病变具有较高的临床指导价值。Objective:To evaluate the diagnostic value of the breast imaging reporting and data system(BI-RADS)in mammography.Methods:911 patients with 1063 breast lesions were retrospectively analyzed for mammography.Two radiologists used BI-RADS to classify enrolled lesions to five degree.Using pathology results as the gold standard,receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficiency of BI-RADS for all lesions and different phenotypes.Results:The accuracy,sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of BI-RADS to diagnose all breast lesions were 87.4%,86.5%,88.5%,90.5%and 83.9%and area under curve(AUC)was 0.924.The results of diagnostic efficiency of BI-RADS for different phenotypes were as follows:in mass lesions and non-mass lesions,the diagnostic AUC were 0.948 and 0.886(P<0.05).The diagnostic AUC for large mass(diameter>2 cm)and small mass(diameter≤2 cm)were 0.955 and 0.929(P<0.05),respectively.While the diagnostic AUC for calcification,asymmetry,architectural distortion were 0.946,0.866,0.843(P<0.05),respectively.In this study,the malignant rates of BI-RADS 3,4A,4B,4C,5 breast lesions were 7.2%,25.2%,75.8%,96.9%,98.7%.Conclusion:BI-RADS has a high value in diagnosis of breast diseases and provides guidance for the follow-up treatment.

关 键 词：乳腺疾病 BI-RADS分类 乳腺X线摄影 诊断价值 

分 类 号：R655.8[医药卫生—外科学] R445.4[医药卫生—临床医学]