摘要
目的:研究乳腺影像学报告及数据系统(BI-RADS)分类对肉芽肿性乳腺炎(GLM)与乳腺癌鉴别诊断的价值。方法:选取在医院就诊的87例乳腺疾病患者超声图像资料,其中43例为GLM(45个病灶),44例为乳腺癌(46个病灶),应用第5版BI-RADS规范化超声词典和分类方法进行超声描述及分类诊断,分析其在GLM与乳腺癌鉴别诊断中的乳腺组织构成、病灶的大小、形状、方位、边缘、回声模式、后方回声特征、钙化以及结构扭曲、导管改变、皮肤改变、水肿和血管分布等相关特征。结果:所有病灶均经病理证实。GLM与乳腺癌在病灶的纵横比、边缘完整性、内部及后方回声、钙化、彩色血流分布以及组织扭曲、皮肤增厚、回缩改变和水肿等相关声像学特征比较,差异具有统计学意义(χ^2=13.580,χ^2=65.188,χ^2=17.160,χ^2=14.887,χ^2=6.131,χ^2=7.893,χ^2=6.284,χ^2=38.748,χ^2=35.708;P<0.05);乳腺组织构成、形状和导管变化比较,差异无统计学意义。BI-RADS分类对GLM和乳腺癌的诊断准确率、灵敏度、特异度、阳性预测值和阴性预测值分别为88.0%、95.7%、80.0%、83.0%和94.7%;ROC曲线下面积为0.878。结论:超声BI-RADS分类通过标准化的描述术语和风险评估分类方法,在GLM和乳腺癌良恶性鉴别诊断评估中操作简单方便、无创有效,具有较高的临床应用价值。
Objective:To explore the values of breast imaging reporting and data system(BI-RADS)classification in the differential diagnosis of GLM and breast cancer.Methods:The ultrasound image data of 87 patients with breast diseases of hospital were selected.Among of them,43 cases were GLM(45 lesions)and 44 were breast cancer(46 lesions).The standardized ultrasound dictionary and classification method of BI-RADS(the 5th edition)were used to implement ultrasound description and classification diagnosis,and to analyze the relevant characteristics of breast tissue composition,lesion size,shape,orientation,edge,echo pattern,posterior echo feature,calcification and structural distortion,duct change,skin change,edema and vascular distribution of them in the differential diagnosis for GLM and breast cancer.Results:All lesions were confirmed by pathology.The differences of series of relevant sound image characteristics included aspect ratio,marginal integrity,internal and posterior echo,calcification,color bloodstream distribution and tissue distortion,skin thickening,changes in retract and edema etc.between GLM and breast cancer were significant(χ^2=13.580,χ^2=65.188,χ^2=17.160,χ^2=14.887,χ^2=6.131,χ^2=7.893,χ^2=6.284,χ^2=38.748,χ^2=35.708,P<0.05).And the differences of composition,shape and duct changes of mammary tissues between GLM and breast cancer were no significant.The diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of BI-RADS classification for GLM and breast cancer were 88.0%,95.7%,80.0%,83.0%and 94.7%,respectively.And the area under the curve(AUC)of receiver operating characteristic(ROC)curve was 0.878.Conclusions:The standardized lexicon terminology and risk assessment categorization of BI-RADS classification of ultrasound ensure it can implement simple and convenient operation,and ensure it can be noninvasive and effective in benignly and malignantly differential diagnosis of GLM and breast cancer.It has higher clinical application value.
作者
林鸣琴
庄淑莲
杨爽
曹君妍
张婷
肖嘉哲
LIN Ming-qin;ZHUANG Shu-lian;YANG Shuang(Department of Ultrasound,Dongguan Traditional Chinese Medicine Hospital,Dongguan 523000,China)
出处
《中国医学装备》
2020年第3期75-79,共5页
China Medical Equipment
基金
广东省医学科学技术研究基金(A2017006)“融合成像技术在腰椎小关节综合症诊疗中的应用研究”
广东省东莞市社会科技发展项目(201650715001588)“调气和营法联合糖皮质激素治疗肉芽肿性乳腺炎的临床观察”。
