超声BI-RADS分类对不同超声分型乳腺良恶性结节的诊断价值

摘要

目的 探讨超声BI-RADS分类对不同超声分型乳腺内结节的诊断价值.方法 选取我院经手术病理证实的乳腺结节患者305例,按照乳腺组织大体的声像图特点,将乳腺分为腺体型、腺纤维Ⅰ型、腺纤维Ⅱ型及脂肪型.以手术病理结果为金标准,应用ROC曲线分析超声BI-RADS分类对各型乳腺内结节的诊断效能.结果 超声BI-RADS分类预测乳腺恶性结节的ROC曲线下面积为0.963,预测不同超声类型乳腺恶性结节的ROC曲线下面积分别为:0.933(腺体型)、0.902(腺纤维Ⅰ型)、0.953(腺纤维Ⅱ型)、0.989(脂肪型);超声BI-RADS分类诊断各型乳腺内结节良、恶性的截断点均为4b~4c.结论 超声BI-RADS分类对不同超声分型乳腺良恶性结节均有良好的诊断效能,且对不同类型乳腺内结节良、恶性鉴别的最佳截断点亦一致.%Objective To evaluate the diagnostic value of ultrasound BI-RADS category in benign and malignant breast nodules in the breast of different ultrasonographic patterns. Methods A total of 305 cases of breast nodules confirmed by surgery and pathology in our hospital were enrolled in this study. According to the whole sonographic features of breast tissue,the breasts were divided into glandular type,gland fiber type Ⅰ,gland fiber type Ⅱ and fat type. The pathology results of nodules were employed as the gold standard,and the diagnostic value of BI-RADS category for the nodules in the breast of different ultrasonographic patterns were analyzed by ROC. Results Area under the ROC curve of BI-RADS category on malignant nodules was 0.963. Areas under the ROC curve of BI-RADS category on malignant nodules in different ultrasonographic patterns were as follows:0.933(glandular type),0.902(gland fiber type Ⅰ),0.953(gland fiber type Ⅱ) and 0.989(fat type),respectively. The benign and malignant cutoff points were between 4b and 4c of ultrasound BI-RADS category in different breast ultrasound types. Conclusion Ultrasound BI-RADS category has a good diagnosing validity on breast nodules in different breast ultrasound types, and the best cut-off points of ultrasound BI-RADS category are consistent in the breast of different ultrasonographic patterns.