声触诊组织成像修正BI-RADS分类在乳腺肿块中的应用价值

摘要

目的 探讨声触诊组织成像(VTI)修正乳腺影像报告与数据系统(BI-RADS)分类在乳腺肿块中的临床应用价值.方法 选取2014年2月至2016年9月因触及乳腺肿块诊治的女性患者195例(206个乳腺肿块),对所有乳腺肿块均于术前行常规超声检查并进行BI-RADS分类,进一步作VTI检查并进行分级,结合VTI分级情况对乳腺肿块的BI-RADS分类结果作进一步修正,并与术后病理检查结果比较分析.结果 良性乳腺肿块的VTI分级主要集中在Ⅰ～Ⅲ级,约占76.43％,而恶性乳腺肿块的VTI分级主要集中在Ⅳ～Ⅴ级,约占84.85％,两者比较差异有统计学意义(P＜0.05).良性乳腺肿块在VTI检查中主要表现为边界不清,约占79.29％,而恶性乳腺肿块在VTI检查中主要表现为边界清楚,约占80.30％,两者比较差异有统计学意义(P＜0.05).VTI修正后BI-RADS分类对乳腺肿块进行良恶性诊断的敏感度、特异度和准确性分别为:92.42％,85.71％,87.86％,其中特异度和准确性明显高于修正前BI-RADS分类的62.86％和70.39％,差异均有统计学意义(均P＜0.05).结论 VTl检查修正常规超声检查所获得的BI-RADS分类结果,有助于进一步提高超声检查对良恶性乳腺肿块的鉴别诊断能力,值得临床上推广应用.%Objective To explore the clinical application value of virtual touch tissue imaging (VTI) corrected the classification of breast imaging report and data system (BI-RADS) in breast masses.Methods A total of 195 female patients who had been treated in our hospital were included in this study from february 2014 to september 2016, due to palpable breast masses.And including a total of 206 breast tumors and the pathologic findings were obtained after surgery.All breast tumors were underwent conventional ultrasound examination and classified by BI-RADS,and then further VTI, combined with the classification of VTI, further adjusted the classification of BI-RADS, and the results were compared with postoperative pathological results.Results The classification of VTI in benign breast tumors mainly concentrated in grade Ⅰ ～Ⅲ, accounted for 76.43％, the classification of VTI in malignant breast tumors mainly concentrated in grade Ⅳ～Ⅴ, accounted for 84.85％, the difference was statistically significant (P＜0.05).Benign breast masses in the VTI mainly showed the not clear boundaries, accounted for 79.29％, malignant breast masses mainly showed the clear boundaries, accounted for 80.30％, the difference was statistically significant (P＜0.05).The sensitivity, specificity and accuracy of the classification of BI-RADS after VTI correction in the diagnosis of breast masses were 92.42％, 85.71％, 87.86％, respectively.The specificity and accuracy were significantly higher than those (62.86％ and 70.39％) before VTI correction, the difference was statistically significant (both P＜0.05).Conclusion VTI corrects the classification of BI-RADS which obtained by conventional ultrasound examination, it will help to further improve the diagnosis ability for benign and malignant breast tumors, and it is worth popularizing in clinical application.