超声结合BI-RADS分级对乳腺非肿块型病变的诊断
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摘要
目的探讨超声结合乳腺影像报告和数据系统分级对乳腺非肿块型病变的诊断情况,提高超声诊断率。方法选取本院在2015年9月～2018年1月收治的乳腺非肿块型病变的患者共68例作为研究对象,对全部患者的病情和资料进行回顾性分析,并将超声诊断结果与病理检查结果进行对比。结果 68例患者中经过病理结果诊断有44例为恶性病变,非恶性病变为24例。超声声像显示片状低回声区占67.65%(46/68),含散微钙化的片状低回声区为25.00%(17/68);簇状以及分布散的微钙化为7.35%(5/68)。超声诊断BI-RADS分级中,3级患者最少,为11例(16.18%);4级患者最多,为39例57.35%,5级患者为18例,占26.47%。根据超声BI-RADS分级进行诊断,4、5级患者判断为恶性,3级以下为良性,本组超声诊断的准确性为77.19%,对于恶性病变的诊断准确率较高,为95.45%;对于非恶性病变的诊断准确率为37.5%。结论超声结合BI-BRDS分级对乳腺非肿块型病变的诊断具有较高的准确性,尤其是对于恶性的非肿块型病变准确性更高,可作为此类疾病的初步筛查和诊断手段。
Objective To explore ultrasound combined withbreast imaging reporting and data system(BI-RADS grading for the diagnosis of non-mass lesions of breast to improve diagnosis rate of ultrasound. Methods 68 patients with non-mass lesions of breastwho were admitted and treated in our hospital from September 2015 to January 2018 were selected as research objects.The conditions and data of all patients were retrospectively analyzed.The results of ultrasonic diagnosis were compared with those of pathological examination. Results Among the 68 patients,44 cases were diagnosed as malignant lesions and 24 cases were diagnosed as non-malignant lesions by pathological results.Ultrasound imaging showed that the patchylow echo areaaccounted for 67.65%(46/68).The patchylow echo area with scattered microcalcificationaccounted for 25.00%(17/68).The patchylow echo area withcluster and scattered microcalcificationsaccounted for 7.35%(5/68).In the BI-RADS grading of ultrasonic diagnosis,patients of grade 3 were the least,accounting for 16.18%(11 cases).Patients of grade 4 were the most,accounting for 57.35%(39 cases) and patients of grade 5 were 18 cases,accounting for 26.47%.According to the ultrasound BI-RADS grading,the patients of grade 4 and 5 werediagnosed to be malignant and those below grade 3 were benign.The accuracy of ultrasound diagnosis was 77.19%.The diagnostic accuracy of malignant lesions was 95.45%,higher than that of non-malignant lesions(37.5%). Conclusion Ultrasound combined with BI-BRDS grading for the diagnosis of non-mass lesions of breast has arelatively high accuracy,especially for malignant non-tumor lesions,which can be used as a preliminary screening and diagnostic tool for such diseases.
Objective To explore ultrasound combined withbreast imaging reporting and data system(BI-RADS grading for the diagnosis of non-mass lesions of breast to improve diagnosis rate of ultrasound. Methods 68 patients with non-mass lesions of breastwho were admitted and treated in our hospital from September 2015 to January 2018 were selected as research objects.The conditions and data of all patients were retrospectively analyzed.The results of ultrasonic diagnosis were compared with those of pathological examination. Results Among the 68 patients,44 cases were diagnosed as malignant lesions and 24 cases were diagnosed as non-malignant lesions by pathological results.Ultrasound imaging showed that the patchylow echo areaaccounted for 67.65%(46/68).The patchylow echo area with scattered microcalcificationaccounted for 25.00%(17/68).The patchylow echo area withcluster and scattered microcalcificationsaccounted for 7.35%(5/68).In the BI-RADS grading of ultrasonic diagnosis,patients of grade 3 were the least,accounting for 16.18%(11 cases).Patients of grade 4 were the most,accounting for 57.35%(39 cases) and patients of grade 5 were 18 cases,accounting for 26.47%.According to the ultrasound BI-RADS grading,the patients of grade 4 and 5 werediagnosed to be malignant and those below grade 3 were benign.The accuracy of ultrasound diagnosis was 77.19%.The diagnostic accuracy of malignant lesions was 95.45%,higher than that of non-malignant lesions(37.5%). Conclusion Ultrasound combined with BI-BRDS grading for the diagnosis of non-mass lesions of breast has arelatively high accuracy,especially for malignant non-tumor lesions,which can be used as a preliminary screening and diagnostic tool for such diseases.
引文
[1]王心怡,张楠,秦王燕,等.乳腺导管原位癌及浸润癌超声表现与病理相关性新探[J].中国超声医学杂志,2017,33(6):498-500.
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[5]罗海愉,钟洁愉,张屿森,等.临床病理及超声多参数评估乳腺癌腋窝淋巴结转移的价值[J].中国超声医学杂志,2018,34(7):590-593.
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[10]葛晖,丁中,王矛,等.BI-RADS-US与弹性成像应变率比值对乳腺肿块的诊断价值[J].中国临床医学影像杂志,2013,24(1):9-12.
[11]高军喜,王颖鑫,王雅婷,等.超声造影特征及定量参数诊断乳腺癌的单因素及多因素分析[J].中国超声医学杂志,2018,34(6):488-491.
[12]白敏,张会萍,张雪梅,等.超声BI-RADS分类联合声触诊组织量化技术鉴别诊断乳腺良恶性病灶的价值探讨[J].临床超声医学杂志,2018,20(6):366-369.
[13]周永刚,袁丽君,邢长洋,等.超声S-Detect分类技术在乳腺包块良恶性诊断中的应用价值[J].中华超声影像学杂志,2017,26(12):1053-1056.
[14]刘婷,周琦,姜珏,等.高频彩色多普勒超声及弹性成像对乳腺髓样癌的诊断价值[J].中国超声医学杂志,2017,33(12):1075-1077.
[15]时兆婷,乐坚,陈雅玲,等.浸润性乳腺癌超声征象与腋下淋巴结转移的相关性研究[J].中华超声影像学杂志,2017,26(5):424-429.
[2]韩广香,周春艳,郑辉.乳腺非肿块型病变的超声诊断[J].影像研究与医学应用,2018,2(11):152-153.
[3]邓椀月,唐丽娜,杨丽春,等.乳腺超声造影预测模型在优化乳腺病灶BI-RADS分类中的价值[J].中华超声影像学杂志,2018,27(4):318-322.
[4]陈慧琪,徐念,过新民,等.特殊类型乳腺癌超声分析[J].中国超声医学杂志,2018,34(8):750-753.
[5]罗海愉,钟洁愉,张屿森,等.临床病理及超声多参数评估乳腺癌腋窝淋巴结转移的价值[J].中国超声医学杂志,2018,34(7):590-593.
[6]魏振玲.乳腺非肿块型病变超声声像图与病理诊断的对照性研究[D].郑州:郑州大学,2017.
[7]李伟伟,丛阳,刘琳,等.超声对乳腺导管原位癌中钙化的初步研究[J].中国超声医学杂志,2018,34(6):495-497.
[8]冯聪.乳腺非肿块型病变的超声诊断分析[J].中国卫生标准管理,2017,8(3):125-126.
[9]刘思雨,牛万彬.乳腺非肿块型病变超声诊断的表现及价值分析[J].中国疗养医学,2017,26(9):996-997.
[10]葛晖,丁中,王矛,等.BI-RADS-US与弹性成像应变率比值对乳腺肿块的诊断价值[J].中国临床医学影像杂志,2013,24(1):9-12.
[11]高军喜,王颖鑫,王雅婷,等.超声造影特征及定量参数诊断乳腺癌的单因素及多因素分析[J].中国超声医学杂志,2018,34(6):488-491.
[12]白敏,张会萍,张雪梅,等.超声BI-RADS分类联合声触诊组织量化技术鉴别诊断乳腺良恶性病灶的价值探讨[J].临床超声医学杂志,2018,20(6):366-369.
[13]周永刚,袁丽君,邢长洋,等.超声S-Detect分类技术在乳腺包块良恶性诊断中的应用价值[J].中华超声影像学杂志,2017,26(12):1053-1056.
[14]刘婷,周琦,姜珏,等.高频彩色多普勒超声及弹性成像对乳腺髓样癌的诊断价值[J].中国超声医学杂志,2017,33(12):1075-1077.
[15]时兆婷,乐坚,陈雅玲,等.浸润性乳腺癌超声征象与腋下淋巴结转移的相关性研究[J].中华超声影像学杂志,2017,26(5):424-429.