高频超声结合BI-RADS分级在乳腺良恶性病变中的应用价值
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摘要
目的探讨高频超声结合BI-RADS分级在乳腺良恶性病变诊断的应用价值。方法选取2016年3月～2017年10月东莞市石碣镇参与"两癌"筛查乳腺体检者2874例,应用超声检查双乳情况。对2874例乳腺体检者进行随访,其中经穿刺检查或手术切除肿物组织病理检查发现,恶性肿瘤17例。以病理诊断结果为对照,评估高频超声结合BI-RADS分级在乳腺良恶性病变诊断的应用价值。结果乳腺恶性病变的高频超声高评分的例数高于良性病变,差异有统计学意义(P<0.05);乳腺恶性病变BIRADS评分Ⅳ级例数高于良性病变,差异有统计学意义(P<0.05);高频超声评分与BI-RADS分级诊断乳腺病变的灵敏度、特异度、准确率、阳性预测值及阴性预测值之间比较,差异无统计学意义(P>0.05);两种方法联合诊断时,其灵敏度、特异度、准确率、阳性预测值及阴性预测值均较单独高频超声评分诊断、单独BI-RADS分级诊断有不同程度的提高,其中两种方法联合诊断时灵敏度和阳性预测值与两种方法单独诊断比较,差异有统计学意义(P<0.05)。结论高频超声检查与BI-RADS评分分级在鉴别诊断乳腺肿块良恶性上具有较高的临床价值,但仍存在一定局限性,两者联合应用在一定程度上能提高乳腺良恶性病变的诊断准确率,是较为理想的检查手段。
Objective To investigate the value of high frequency ultrasound combined with BI-RADS classification in the diagnosis of benign and malignant breast lesions. Methods A total of 2874 patients who underwent "two cancers" screening for breast examinations from March 2016 to October 2017 in Shijie town were enrolled. A total of 2874 breast examinations were followed up. Among them, 17 cases of malignant tumors were found by histopathological examination of puncture or surgical resection. The pathological diagnosis was used as a control to evaluate the value of high frequency ultrasound combined with BI-RADS classification in the diagnosis of benign and malignant breast lesions. Results The number of highfrequency ultrasound high scores of malignant breast lesions was significantly higher than that of benign lesions, the difference was statistically significant(P<0.05). The number of grade IV of BI-RADS scores of breast malignant lesions was higher than that of benign lesions,the difference was statistically significant(P <0.05); there was no significant difference between the high-frequency ultrasound score and the sensitivity, specificity,accuracy, positive predictive value and negative predictive value of BI-RADS graded diagnosis of breast lesions( P>0.05).When combined with the two methods, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were improved to different degrees compared with the diagnosis of high-frequency ultrasound score alone and BI-RADS graded diagnosis alone. The time sensitivity and positive predictive value were compared with the two methods alone,the difference was statistically significant(P<0.05). Conclusion High-frequency ultrasonography and BI-RADS scoring have high clinical value in the differential diagnosis of benign and malignant breast masses, but there are still some limitations. The combination of the two can improve the diagnosis of benign and malignant breast lesions to a certain extent. The rate is an ideal means of inspection.
Objective To investigate the value of high frequency ultrasound combined with BI-RADS classification in the diagnosis of benign and malignant breast lesions. Methods A total of 2874 patients who underwent "two cancers" screening for breast examinations from March 2016 to October 2017 in Shijie town were enrolled. A total of 2874 breast examinations were followed up. Among them, 17 cases of malignant tumors were found by histopathological examination of puncture or surgical resection. The pathological diagnosis was used as a control to evaluate the value of high frequency ultrasound combined with BI-RADS classification in the diagnosis of benign and malignant breast lesions. Results The number of highfrequency ultrasound high scores of malignant breast lesions was significantly higher than that of benign lesions, the difference was statistically significant(P<0.05). The number of grade IV of BI-RADS scores of breast malignant lesions was higher than that of benign lesions,the difference was statistically significant(P <0.05); there was no significant difference between the high-frequency ultrasound score and the sensitivity, specificity,accuracy, positive predictive value and negative predictive value of BI-RADS graded diagnosis of breast lesions( P>0.05).When combined with the two methods, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were improved to different degrees compared with the diagnosis of high-frequency ultrasound score alone and BI-RADS graded diagnosis alone. The time sensitivity and positive predictive value were compared with the two methods alone,the difference was statistically significant(P<0.05). Conclusion High-frequency ultrasonography and BI-RADS scoring have high clinical value in the differential diagnosis of benign and malignant breast masses, but there are still some limitations. The combination of the two can improve the diagnosis of benign and malignant breast lesions to a certain extent. The rate is an ideal means of inspection.
引文
[1]李涛,林剑英.高频超声钙化特征与弹性成像对乳腺结节的诊断价值[J].贵阳医学院学报,2015,40(6):644-646.
[2]王旭,黄淑华,刘新红,等.联合应用超声弹性成像及彩色多普勒在诊断乳腺癌及评价TNM分期中的价值[J].天津医药,2014,42(2):119-122.
[3]朱爱民.乳腺结节行高频彩色多普勒超声的诊断价值[J].实用医学,2014,20(12):65-66.
[4]徐梅,陈静,魏兰萍.高频超声对不同大小乳腺病灶的诊断比较及分析[J].中华临床医师杂志(电子版),2013,7(19):8935-8937.
[5]付贵丽,张云江,苟绍银.探讨高频彩色多普勒超声对乳腺结节的诊断价值[J].云南医药,2014,35(1):97-99.
[6]曾福强,黄志勇,罗平平.彩色多普勒超声对非典型乳腺癌的诊断分析[J].现代医用影像学,2014,23(4):373-375.
[7]吴迎,周庆华,王怡.BI-RADS分级在乳腺肿瘤临床诊断中的应用价值.肿瘤,2017,37(6):281-288.
[8]谷云芝,左莉莉,王文娟,等.BI-RADS分级在乳腺癌诊断中的应用[J].山东医药,2015,55(27):54-55.
[9]赵宏,崔钟鸣.超声简化的BI-RADS分级诊断标准对乳腺病变的诊断价值[J].航空航天医学杂志,2013,24(5):578-579.
[10]卢建明,赵淑红,田锦,等.乳腺超声检查中BI-RADS分级诊断标准对乳腺肿瘤的诊断价值[J].宁夏医学杂志,2015,37(2):140-142.
[11]彭瑞芳,杨韵贤,郑苑君,等.超声弹性成像与BI-RADSUS分级在乳腺良恶性肿块中的诊断价值[J].中国当代医药,2016,23(7):124-126.
[12]王艳,王辉,查晓霞.BI-RADS分级在彩超检查乳腺良、恶性结节中的规范化应用[J].现代结节医学,2015,23(3):403-406.
[13]Fowler EE,Sellers TA,Heine JJ.Breast Imaging Reporting and Data Systerm(BI-RADS)breast composition descriptors:automated measurement development for full field digital mammography[J].Med Phys,2013,40(11):113502.
[14]Yu HW,Wu J,Zhai QY.The application of high-frequency ultrasound in the diagnosis of breast small solid tumors[J].Modem Preven Med,2012,39(9):2261-2263,2268.
[2]王旭,黄淑华,刘新红,等.联合应用超声弹性成像及彩色多普勒在诊断乳腺癌及评价TNM分期中的价值[J].天津医药,2014,42(2):119-122.
[3]朱爱民.乳腺结节行高频彩色多普勒超声的诊断价值[J].实用医学,2014,20(12):65-66.
[4]徐梅,陈静,魏兰萍.高频超声对不同大小乳腺病灶的诊断比较及分析[J].中华临床医师杂志(电子版),2013,7(19):8935-8937.
[5]付贵丽,张云江,苟绍银.探讨高频彩色多普勒超声对乳腺结节的诊断价值[J].云南医药,2014,35(1):97-99.
[6]曾福强,黄志勇,罗平平.彩色多普勒超声对非典型乳腺癌的诊断分析[J].现代医用影像学,2014,23(4):373-375.
[7]吴迎,周庆华,王怡.BI-RADS分级在乳腺肿瘤临床诊断中的应用价值.肿瘤,2017,37(6):281-288.
[8]谷云芝,左莉莉,王文娟,等.BI-RADS分级在乳腺癌诊断中的应用[J].山东医药,2015,55(27):54-55.
[9]赵宏,崔钟鸣.超声简化的BI-RADS分级诊断标准对乳腺病变的诊断价值[J].航空航天医学杂志,2013,24(5):578-579.
[10]卢建明,赵淑红,田锦,等.乳腺超声检查中BI-RADS分级诊断标准对乳腺肿瘤的诊断价值[J].宁夏医学杂志,2015,37(2):140-142.
[11]彭瑞芳,杨韵贤,郑苑君,等.超声弹性成像与BI-RADSUS分级在乳腺良恶性肿块中的诊断价值[J].中国当代医药,2016,23(7):124-126.
[12]王艳,王辉,查晓霞.BI-RADS分级在彩超检查乳腺良、恶性结节中的规范化应用[J].现代结节医学,2015,23(3):403-406.
[13]Fowler EE,Sellers TA,Heine JJ.Breast Imaging Reporting and Data Systerm(BI-RADS)breast composition descriptors:automated measurement development for full field digital mammography[J].Med Phys,2013,40(11):113502.
[14]Yu HW,Wu J,Zhai QY.The application of high-frequency ultrasound in the diagnosis of breast small solid tumors[J].Modem Preven Med,2012,39(9):2261-2263,2268.