BI-RADS分级系统诊断在提高乳腺良恶性病变鉴别诊断中的临床价值
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摘要
目的探讨BI-RADS分级系统在乳腺良恶性病变鉴别诊断中的临床价值。方法从2017年1月初开始筛选患者,截止2018年1月底,共纳入422例乳腺肿瘤患者(共559个乳腺肿块)为研究对象,均采用彩色多普勒超声诊断仪对其进行常规超声检查,并按BI-RADS分级系统对患者进行诊断。对结果进行分析比较。结果 BI-RADS分级0级共3个肿块,均为良性;1级0个;2级22个肿块,均为良性;3级482个肿块中13个恶性;4a级33个肿块中6个恶性,4b级9个肿块中4个恶性,4c级7个肿块中6个恶性;5级3个肿块均为恶性;6级0个;4级系统对乳房肿块良恶性诊断的敏感度、特异度、阳性预测值、阴性预测值均较好;乳腺恶性肿块形态不规则、边界不清晰、内部回声低、周围组织不完整、血供丰富及腋下有淋巴结肿大,与乳腺良性肿块相比差异有统计学意义(P<0.05)。结论 BI-RADS分级系统在乳腺肿瘤诊断中有较好的有应用价值,值得推广。
【Objective】To probe into the clinical value of BI-RADS classification system diagnosis in improving the differential diagnosis of benign and malignant breast lesions.【Methods】Totally 422 patients with breast cancer(559 breast masses)who screened from January 2017 to January 2018 were included as the research object, and were given the routine ultrasound examination by the color Doppler ultrasound diagnostic instrument, and the patients were diagnosed according to the BI-RADS grading system. Then, the both results were analyzed and compared.【Results】There were 3 cases of BI-RADS grade 0, and all were benign. There were 0 cases in Grade 1 and 22 cases in grade 2, all were benign. There were 482 cases of mass in grade 3 and13 cases were malignant. There were 33 cases of lumps in grade 4 a and 6 cases were malignant. There were 9 cases of lumps in grade 4 b, and 4 cases were malignant. There were 7 cases of lumps in grade 4 c, and 6 cases were malignant. There were 3 cases in grade 5, and 3 cases were malignant. There were 0 cases in grade 6. The sensitivity, specificity, positive predictive value and negative predictive value of the four grading system for the diagnosis of benign and malignant breast masses were good. The malignant tumor of mammary gland was irregular, the boundary was not clear, the internal echo was low, the surrounding tissue was not complete, the blood supply was rich and the axillary lymph nodes were swollen, and the difference was statistically significant compared with the benign breast mass(P <0.05).【Conclusion】The BI-RADS grading system has a good application value in the diagnosis of breast tumors, thus it is worth promoting.
【Objective】To probe into the clinical value of BI-RADS classification system diagnosis in improving the differential diagnosis of benign and malignant breast lesions.【Methods】Totally 422 patients with breast cancer(559 breast masses)who screened from January 2017 to January 2018 were included as the research object, and were given the routine ultrasound examination by the color Doppler ultrasound diagnostic instrument, and the patients were diagnosed according to the BI-RADS grading system. Then, the both results were analyzed and compared.【Results】There were 3 cases of BI-RADS grade 0, and all were benign. There were 0 cases in Grade 1 and 22 cases in grade 2, all were benign. There were 482 cases of mass in grade 3 and13 cases were malignant. There were 33 cases of lumps in grade 4 a and 6 cases were malignant. There were 9 cases of lumps in grade 4 b, and 4 cases were malignant. There were 7 cases of lumps in grade 4 c, and 6 cases were malignant. There were 3 cases in grade 5, and 3 cases were malignant. There were 0 cases in grade 6. The sensitivity, specificity, positive predictive value and negative predictive value of the four grading system for the diagnosis of benign and malignant breast masses were good. The malignant tumor of mammary gland was irregular, the boundary was not clear, the internal echo was low, the surrounding tissue was not complete, the blood supply was rich and the axillary lymph nodes were swollen, and the difference was statistically significant compared with the benign breast mass(P <0.05).【Conclusion】The BI-RADS grading system has a good application value in the diagnosis of breast tumors, thus it is worth promoting.
引文
[1]陈万青,郑荣寿,张思维,等. 2012年中国恶性肿瘤发病和死亡分析[J].中国肿瘤, 2016, 25(1):1-8.
[2]陈圆圆,李智贤,廖新红,等.超声诊断体系对乳腺良、恶性病变的鉴别诊断价值[J].广西医科大学学报, 2017, 34(3):379-382.
[3]刘兰,许传塍,李斌.超声弹性成像不同参数应用于诊断乳腺良恶性肿瘤中的可行性研究[J].基层医学论坛, 2017, 7(7):848-849.
[4]刘琳,吴蓉,吴晶心,等.常规超声检查联合声触诊组织成像技术鉴别诊断乳腺良恶性病变的价值[J].中华医学超声杂志(电子版), 2016, 13(6):466-470.
[5]顾素杰.超声弹性成像及彩色多普勒对乳腺良恶性占位的诊断价值[J].中国医疗器械信息, 2017, 23(7):62-64.
[6]郝建华,张连仲.高频彩色多普勒超声诊断乳腺肿块的临床应用价值分析[J].临床医学, 2016, 36(12):109-110.
[7]官宏勇.浅论超声检查在早期乳腺癌与乳腺良性肿瘤鉴别诊断中的应用价值[J].当代医药论丛, 2017, 15(5):134-135.
[8]赵青,牟洋,赵献萍,等.超声弹性成像与钼靶对乳腺肿块BI-RADS分类诊断价值[J].中华实用诊断与治疗杂志, 2017,31(6):589-591.
[9]马燕,郭嵩,李晶,等.超微血管成像技术联合超声BI-RADS分级在鉴别乳腺良恶性肿物中应用价值[J].中国临床医学影像杂志, 2016, 27(1):10-13.
[10]刘健,高云华,苟凌云,等.实时超声造影对提高乳腺肿瘤BI-RADS分类准确性的价值[J].中国医学影像学杂志, 2016,24(4):281-284,288.
[11]娄晓娟,黄文杰,陈镇平,等. BI-RADS系统与Fisher's评分联合应用在3.0T磁共振对乳腺疾病定性诊断中的价值[J].全科医学临床与教育, 2016, 14(4):413-415,419.
[12]左文思,冷晓玲,马富成.超声造影对乳腺BI-RADS4B级肿块的诊断价值[J].海南医学, 2016, 27(2):231-235.
[2]陈圆圆,李智贤,廖新红,等.超声诊断体系对乳腺良、恶性病变的鉴别诊断价值[J].广西医科大学学报, 2017, 34(3):379-382.
[3]刘兰,许传塍,李斌.超声弹性成像不同参数应用于诊断乳腺良恶性肿瘤中的可行性研究[J].基层医学论坛, 2017, 7(7):848-849.
[4]刘琳,吴蓉,吴晶心,等.常规超声检查联合声触诊组织成像技术鉴别诊断乳腺良恶性病变的价值[J].中华医学超声杂志(电子版), 2016, 13(6):466-470.
[5]顾素杰.超声弹性成像及彩色多普勒对乳腺良恶性占位的诊断价值[J].中国医疗器械信息, 2017, 23(7):62-64.
[6]郝建华,张连仲.高频彩色多普勒超声诊断乳腺肿块的临床应用价值分析[J].临床医学, 2016, 36(12):109-110.
[7]官宏勇.浅论超声检查在早期乳腺癌与乳腺良性肿瘤鉴别诊断中的应用价值[J].当代医药论丛, 2017, 15(5):134-135.
[8]赵青,牟洋,赵献萍,等.超声弹性成像与钼靶对乳腺肿块BI-RADS分类诊断价值[J].中华实用诊断与治疗杂志, 2017,31(6):589-591.
[9]马燕,郭嵩,李晶,等.超微血管成像技术联合超声BI-RADS分级在鉴别乳腺良恶性肿物中应用价值[J].中国临床医学影像杂志, 2016, 27(1):10-13.
[10]刘健,高云华,苟凌云,等.实时超声造影对提高乳腺肿瘤BI-RADS分类准确性的价值[J].中国医学影像学杂志, 2016,24(4):281-284,288.
[11]娄晓娟,黄文杰,陈镇平,等. BI-RADS系统与Fisher's评分联合应用在3.0T磁共振对乳腺疾病定性诊断中的价值[J].全科医学临床与教育, 2016, 14(4):413-415,419.
[12]左文思,冷晓玲,马富成.超声造影对乳腺BI-RADS4B级肿块的诊断价值[J].海南医学, 2016, 27(2):231-235.