超声诊断乳腺BI-RADS Ⅳa类结节在外科诊疗中的价值及病理结果对比  

Value of Ultrasonography in Diagnosis and Treatment of Breast BIRADS Ⅳa Nodules and Comparison with Pathological Results

作　　者：郑蔚朗 王丹丹 ZHENG Weilang;WANG Dandan(Department of Ultrasound,Yong'an Municipal Hospital of Fujian Province,Yong'an Fujian 366000,China)

机构地区：[1]福建省永安市立医院超声科,福建永安366000

出　　处：《中国卫生标准管理》2022年第18期96-100,共5页China Health Standard Management

摘　　要：目的分析并证实乳腺影像报告与数据系统(breast imaging reporting and data system,BI-RADS)Ⅳa类结节的超声诊断在乳腺外科诊疗中的价值,以进一步提高超声对乳腺结节定性的精准性。方法研究区间为2015年12月—2021年12月,研究对象为该区间福建省永安市立医院乳腺外科手术患者共计79例。视穿刺活检或手术的病理结果为金标准,对所纳入病例均行常规高频超声诊断,与手术病理结果比较评价乳腺BI-RADSⅣa类结节的超声诊断作用。结果79例乳腺BI-RADSⅣa类结节,术前超声诊断提示倾向良性结节64个,倾向恶性结节15个;术后病理结果显示良性结节61个,恶性结节18个。超声检查对乳腺良性结节的定性诊断的符合率为93.8%,对恶性结节诊断符合率93.3%,诊断一致性Kappa指数为0.809(P<0.001),受试者工作特征曲线(receiver operating characteristic curve,ROC curve)下面积达88.1%(95%可信区间:78.1%~98.1%)。结论超声诊断乳腺BI-RADS Ⅳa类结节,具备较高的诊断精准性,可为临床诊疗、预后提供影像参考。Objective To evaluate the value of ultrasound diagnosis of breast imaging reporting and data system(BI-RADS)Ⅳa nodules in breast surgery,in order to further improve the accuracy of ultrasound in the diagnosis of breast nodules.Methods A total of 79 patients diagnosed by conventional high-frequency ultrasound and conducted breast surgery in Yong’an Municipal Hospital of Fujian Province between December 2015 and December 2021 were recruited in this study.The pathological results of needle biopsy or surgery were considered the golden standard,and routine high-frequency ultrasound diagnosis was performed on all included cases.Compared with the pathological results of surgery,the ultrasound diagnosis of breast BIRADS Ⅳa nodules was evaluated.Results Among 79 cases of Ⅳa breast nodules,ultrasound diagnosis showed 64 benign nodules and 15malignant nodules,while the pathological results showed 61 benign nodules and 18 malignant nodules.The agreement rate of ultrasound in the qualitative diagnosis of benign breast nodules was 93.8%,and that of malignant nodules was 93.3%.The Kappa index was 0.809(P<0.001)and the area under the receiver operating characteristic(ROC)curve was 88.1%(95% Confidence interval:78.1%~98.1%),showing high agreement and accuracy of the ultrasound diagnosis.Conclusion Ultrasound diagnosis of breast BI-RADS Ⅳa nodules has high diagnostic accuracy,which may provide a reference for clinical diagnosis,treatment,and prognosis.

关 键 词：常规高频超声 乳腺BI-RADS系统 Ⅳa类结节 恶性征像 病理结果 诊断精准性 

分 类 号：R445[医药卫生—影像医学与核医学]