超声BI—RADS分级标准指导判断乳腺肿块良恶性的价值

目的：探讨超声乳腺影像报告和数据系统（Breastimagingreportinganddatasystem，BI—RADS）分级诊断标准在乳腺肿块良恶性鉴别中的应用价值。方法：选取行乳腺彩色多普勒超声检查的患者93例（共121个乳腺肿块）。采用BI—RADS分级诊断标准对乳腺肿块进行分级，根据超声表现对肿块做出良恶性的判断。比较良恶性肿块超声图像的差异并分析BI—RADS分级诊断标准对肿块良恶性鉴别的性能。结果：乳腺恶性肿块形态不规则，边界不清晰、内部呈低回声、周围组织不完整、血供丰富以及有腋下淋巴结肿大，与乳腺良性肿块相比，差异具有统计学意义（P〈0．05）。除BI—RADS分级诊断标准中4B级肿块的阳性预测值稍低外（50％），其余级别乳腺肿块对良恶性鉴别的敏感度、特异度、阳性预测值及阴性预测值均较好（66．67％。100％）。特别是1、2、3级及5级的肿块，其良恶性判断结果与病理结果完全一致。结论：乳腺恶性肿块形态不规则，边界不清晰、内部呈低回声、周围组织不完整、血供丰富以及有腋下淋巴结肿大。超声BI—RADS分级诊断标准具有较好的鉴别乳腺肿块良恶性的能力。

Values of breast ultrasonography using BI-RADS classification in differentiating benign and malignant breast masses

Objective： To investigate the diagnostic value of breast ultrasonography following BI-RADS in differentiating benign and malignant breast masses. Methods： Ninety-three patients with 121 breast masses underwent bilateral breast exami- nation with high-frequency color Doppler ultrasonography. All the breast masses were evaluated with BI-RADS classification. The difference of ultrasound image between the benign and malignant breast masses was compared. The diagnostic value of BI-RADS on benign and malignant breast masses was evaluated by the parameters of sensitivity, specificity, positive and neg- ative predictive value. Results： Compared with the benign breast masses, the malignant breast masses showed hypoechoic, ir- regular shape, unclear boundary, incomplete surrounding tissue, rich blood supply and with intumescent axiUary lymph node. The difference was statistically significant （P〈0.05）. Except the positive predictive value of grade 4B （50%）, the sensitivity, specificity, positive predictive value and negative predictive value of all the grades were satisfactory （66.67%-100%）, especially the grades 1, 2, 3, 5 in which the result were same as the pathological findings. Conclusion： The malignant breast masses showed hypoechoic, irregular shape, unclear boundary, incomplete surrounding tissue, rich blood supply and with intumescent axillary lymph node. BI-RADS classification was accurate for distinguishing benign and malignant breast masses.