超声乳腺影像报告和数据系统分级对乳腺结节病变性质的鉴别诊断及声像图特征分析  

Ultrasonic breast imaging reporting and data system grading for differential diagnosis of breast nodular lesions and analysis of sonographic features

作　　者：李沆 Li Hang(Department of Health Examination,Zhengzhou Cardiovascular Hospital,Zhengzhou Seventh People′s Hospital,Henan 450000,China)

机构地区：[1]河南省郑州市心血管病医院,郑州市第七人民医院健康体检科,450000

出　　处：《实用医技杂志》2022年第12期1260-1264,共5页Journal of Practical Medical Techniques

基　　金：河南省医学科技攻关项目(LHGJ202100621)。

摘　　要：目的 观察乳腺影像报告和数据系统(BI-RADS)分级对乳腺结节患者病变性质的鉴别诊断价值,并分析声像图特征。方法 回顾性分析郑州市第七人民医院2020年1月至2022年5月接受乳腺病变筛查的3 000例女性临床资料,首先将其中200例存在乳腺结节病变的患者作为研究对象为病例组,其余2800例为对照组,统计并对比2组的BI-RADS分级情况;再根据手术病理结果,将200例阳性患者中,19例诊断为恶性病变的患者列为恶性组,将其余181例患者列为良性组,比较2组患者的BI-RADS分级情况及影像学特征,以病理结果为标准分析BI-RADS分级对乳腺病变及乳腺结节病变性质的诊断效能。结果 3000例女性中170例BI-RADS分级在4A级以上,诊断为阳性病例,2 511例BI-RADS分级在4A级及以下,诊断为阴性病例,BI-RADS对乳腺病变的诊断准确率为89.37%(2 681/3 000)、敏感度为85.00%(170/200)、特异度为89.68%(2 511/2 800);经超声检查后,恶性组内患者的BI-RADS分级多在4C级及以上,其声像图特征多表现为体积较大、非平行方位、边缘呈毛刺征、有明显回声、粗大钙化征、伴淋巴结融合、皮髓质边界模糊的不规则病灶,与良性组患者存在明显差异;依据手术病理结果,良性组内患者的BI-RADS分级主要为4A、4B级,BI-RADS对恶性病变患者的诊断准确率为85.50%(171/200)、敏感度为84.21%(16/19)、特异度为85.64%(155/181)。结论 超声BI-RADS分级可实现对乳腺病变患者的初步筛查,结合患者的声像图特征可对乳腺结节患者的病变性质进行有效鉴别,超声BI-RADS分级对乳腺结节病变患者具有较高诊断效能。Objective To investigate the value of breast imaging reporting and data system(BI-RADS)grading in differential diagnosis of breast nodules,and to analyze the related sonographic features.Methods The clinical data of 3000 women who underwent breast screening in Zhengzhou Seventh People′s Hospital between January 2020 and May 2022 were retrieved and retrospectively analyzed.Of these,200 women with nodular breast lesions were included as study subjects(patient group),and the remaining 2800 were assigned to the control group.The two groups were reviewed and compared for the BI-RADS grading on ultrasonography.According to post-surgical pathology of the 200 positive patients,19 with confirmed malignany were divided to the malignant group,and the remaining 181 patients to the benign group.The BI-RADS grading and sonogr-aphic features in these two groups were compared.Using pathological findings as the gold standard,we evalu-ated the diagnostic performance of BI-RADS grading in determining the nature of breast lesions and nodular breast lesions.Results Among the 3000 women,170 with BI-RADS grades higher than 4A and classified as positive cases,and 2511 with BI-RADS grades 4A or below as negative cases.Overall,the BI-RADS grading yielded a diagno-stic ac-curacy of 89.37%(2681/3000),a sensitivity of 85.00%(170/200),and a specificity of 89.68%(2511/2800)for breast lesions.By ultrasonography,lesions in the malignant group were mostly of BI-RADS grades 4C or above,featured by irregular shape,large size,non-parallel orientation,spiculation sign,obvious echogenicity,coarse calcification,lymph node fusion,and blurred corticomedullary boundary,which were significantly dif-ferent from those in the benign group.According to postoperative pathology,lesions of patients in the benign group were chiefly of BI-RADS grades 4A and 4B.For malignant breast lesions,BI-RADS grading yielded a di-agnostic accuracy of 85.50%(171/200),a sensitivity of 84.21%(16/19),and a specificity of 85.64%(155/181).Conclusion Ultrasound BI-RADS grading quali

关 键 词：乳腺疾病 数据系统 表面特性 超声检查 乳房 诊断 

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]