新版乳腺影像报告与数据系统分类法和声触诊组织成像定量技术对乳腺结节良恶性的诊断价值

摘要

Objective To investigate values of new edition breast imaging reporting and data system (BI-RADS) and virtual touch tissue imaging quantification(VTIQ) in the diagnosis of benign and malignant breast lesion.Methods Totally 298 patients with breast lesion from June 2014 to July 2015 in Tenth People's Hospital of Tongji University were enrolled,with a total of 302 breast lesion diagnosed by pathologic examination.According to the diameter of lesion,all patients were divided into ≤10 mm group,＞ 10-20 mm group and ＞20 mm group.BI-RADS and VTIQ were used to analyze each lesion;diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy were calculated.Receiver operating characteristic (ROC) curves were evaluated for diagnostic efficiency.Results Pathologic examination confirmed 90 malignant lesion and 212 benign lesion.Results of BI-RADS showed 9l malignant and 211 benign lesion.VTIQ showed 101 malignant and 201 benign lesion.Combined diagnostic results of BI-RADS and VTIQ showed 120 malignant lesion and 182 benign lesion;the combined diagnosis had high sensitivity,accuracy and AUC,which were 94.44％,87.42％ and 0.894 respectively.In diameter ≤ 10 mm group,the diagnostic accuracy of VTIQ was 95.06％ and area under ROC curve (AUC) was 0.931.In diameter ＞ 10-20 mm group,the sensitivity of combined diagnosis was 94.74％,the accuracy was 88.54％ and AUC was 0.906.In diameter ＞ 20 mm group,the diagnostic sensitivity of BI-RADS was 90.91％,the accuracy was 79.69％ and AUC was 0.793.Conclusions Combined application of BI-RADS and VTIQ is helpful to improve the diagnostic accuracy of breast cancer.For small lesion with diameter≤ 10 mm,VTIQ has a better diagnostic efficiency;for large lesion with diameter ＞ 20 mm,BI-RADS has more advantageous.%目的 探讨新版乳腺影像报告与数据系统(BI-RADS)分类法、声触诊组织成像定量(VTIQ)技术以及二者联合应用对乳腺结节良恶性的诊断价值.方法 回顾性分析2014年6月至2015年7月于同济大学附属第十人民医院就诊的298例患者共计302个经病理证实的乳腺结节的超声图像资料,统计分析每个结节的BI-RADS分类、VTIQ检查时结节内部平均剪切波速度(SWV)以及联合应用2种方法诊断的敏感度、特异度、阳性预测值、阴性预测值和诊断正确率,分别构建3种诊断方法的受试者工作特征曲线,获取曲线下面积(AUC),评价各种方法的诊断效能,并对3种诊断方法做差异性检验.按照病灶直径大小分为3组,直径≤10 mm组,直径＞10 ～20 mm组,直径＞20 mm组,对每组均按照以上统计方法做分析,评价3种诊断方法对不同大小乳腺结节良恶性的诊断价值.结果 病理诊断恶性结节90个、良性212个.BI-RADS分类法诊断恶性结节91个、良性211个.VTIQ检查诊断恶性结节101个、良性201个.二者联合诊断恶性结节120个、良性182个.未分组时二者联合诊断的敏感度、正确率和AUC最高,分别为94.44％、87.42％和0.894.对于直径≤10 mm组,VTIQ诊断正确率高达95.06％,AUC为0.931.对于直径＞ 10 ～ 20 mm组,联合诊断的敏感度为94.74％,正确率为88.54％,AUC为0.906.对于直径＞20 mm组,BI-RADS分类法诊断敏感度为90.91％,正确率为79.69％,AUC为0.793.结论 联合应用BI-RADS分类法和VTIQ技术有利于提高乳腺癌的诊断正确率,二者联合应用优于其中任何一种单一方法.对于直径≤10 mm的乳腺小结节,VTIQ技术具有较好的诊断效能.对于直径＞20 mm的乳腺结节,BI-RADS分类法更有优势.