超声BI-RADS在乳腺叶状肿瘤良恶性鉴别中的价值  

Value of BI-RADS in distinguishing benign from malignant phyllodes tumors of the breast

作　　者：王会敏[1] 潘云祥[1] 肖祎炜[1] 万舰[2] 刘向娇[1] 尚宁[1] 王丽敏[1] Wang Huimin;Pan Yunxiang;Xiao Yiwei;Wan Jian;Liu Xiangjiao;Shang Ning;Wang Limin(Department of Ultrasound,Guangdong Women and Children Hospital,Guangzhou 511400,China;Department of Breast,Guangdong Women and Children Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院超声科,广州511400 [2]广东省妇幼保健院乳腺科,广州511400

出　　处：《国际医药卫生导报》2021年第24期3781-3784,共4页International Medicine and Health Guidance News

基　　金：广东省科技计划项目(2020A1414010170)。

摘　　要：目的探讨超声乳腺影像报告与数据系统(BI-RADS)在乳腺叶状肿瘤良恶性鉴别中的价值。方法回顾性分析2015年1月至2021年8月就诊于广东省妇幼保健院的57例经手术治疗及病理证实的乳腺叶状肿瘤患者的病例资料,均为女性,年龄(39.3±10.7)岁,对超声图像进行BI-RADS分类。采用Kappa系数分析不同级别医生分类结果的一致性。比较良性、交界性及恶性叶状肿瘤的肿块最大径线、超声表现、超声BI-RADS。以病理结果为金标准,交界性和恶性肿块为恶性组,良性肿块为良性组,采用受试者工作特征曲线(ROC)计算超声表现及BI-RADS对恶性肿块的诊断效能。结果不同级别医生应用BI-RADS对肿块分类的一致性好(Kappa=0.778,P<0.001)。不同病理类型的患者发病年龄、乳腺肿块最大径线、形态、边缘、内部回声、BI-RADS分类之间的差异均有统计学意义(均P<0.05),血流之间的差异无统计学意义(P>0.05)。BI-RADS诊断恶性肿块的界值为BI-RADS 4B类。肿块的最大径线、形态、边缘、内部回声、BI-RADS诊断恶性肿块的曲线下面积分别为0.760、0.755、0.672、0.764、0.829,灵敏度分别为96.0%、75.0%、31.3%、68.7%、65.6%,特异度分别为53.1%、76.0%、96.0%、84.0%、88.0%。结论超声BI-RADS可减少不同级别医生间的主观差异性,利于临床推广与规范应用,其对乳腺叶状肿瘤良恶性鉴别诊断较单一的超声表现也具有更高的诊断效能。Objective To investigate the value of ultrasound breast imaging reporting and data system(BI-RADS)in the differential diagnosis of benign and malignant phyllodes tumors of the breast.Methods The clinical data of 57 patients with phyllodes tumors of the breast confirmed by surgery and pathology treated in Guangdong Women and Children Hospital from January 2015 to August 2021 were retrospectively analyzed,all female,aged(39.3±10.7)years,and the ultrasound images were classified by BI-RADS.Kappa value was used to analyze the consistency of classification results of doctors with different levels.The diameter,ultrasonic characteristics,and ultrasonic BI-RADS of benign,borderline,and malignant phyllodes tumors were compared.With the pathological results as the gold standard,the borderline and malignant tumors as the malignant group,and the benign tumors as the benign group,the diagnostic efficacy of BI-RADS for malignant tumors was calculated by the receiver operating characteristic curve(ROC).Results The consistency of the classification of masses using BI-RADS by doctors with different levels was good(Kappa=0.778,P<0.001).There were statistically significant differences in the age,diameter,shape,edge,internal echo,and BI-RADS classification among patients with different pathological types(all P<0.05),but there was no statistically significant difference in the blood flow of tumors(P>0.05).The boundary value of BI-RADS classification in the diagnosis of malignant tumors was BI-RADS 4B.The areas under the curve of the diameter,shape,edge,internal echo,and BI-RADS in the diagnosis of malignant tumors were 0.760,0.755,0.672,0.764,and 0.829,the sensitivities were 96.0%,75.0%,31.3%,68.7%,and 65.6%,and the specificities were 53.1%,76.0%,96.0%,84.0%,and 88.0%.Conclusions Ultrasound BI-RADS can reduce the subjective differences among doctors at different levels,is conducive to the clinical promotion and standardized application.Compared with single ultrasound performance,ultrasound BI-RADS has higher diagnostic performance i

关 键 词：超声乳腺影像报告与数据系统 乳腺叶状肿瘤 良恶性 

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