目的：探讨超声弹性成像对BI-RADS 3、4级乳腺病变的临床诊断价值。方法：选择106例患者128个BI-RADS 3、4级病灶，联合弹性成像评分法对其进行调整，并与术后病理结果进行对照，采用受试者工作（ROC）曲线评价两者联合应用对乳腺病变的诊断价值。结果：128个病灶中，恶性病灶62个，良性病灶66个。调整前BI-RADS分类对恶性肿块诊断的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为87.0%、79.7%、82.8%、75.8%和89.4%；联合弹性成像调整后的BI-RADS分类对恶性肿块诊断的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为95.1%、94.0%、94.5%、93.5%和94.5%。调整后的BI-RADS分类的ROC曲线下面积为0.945，明显高于调整前的0.826（Z=2.63，P<0.05）。结论：超声弹性成像能够提高BI-RADS 3级病变中恶性病变的检出率，能够减少BI-RADS 4级病变中不必要的活检。
Abstract
Objective: To explore the diagnostic value of sonoelastography on BI-RADS category 3 and 4 breast lesions. Methods: One hundred and twenty eight breast lesions in 106 women which were classified as BI-RADS category 3 and 4 were examined with ultrasound and sonoelastography. Sonoelastography was used to adjust the BI-RADS classification. The results were further compared with those of postoperative pathology. The receiver operating characteristic(ROC) curve was employed to evaluate the combined use on breast lesions. Results: Among the 128 breast lesions, 62 cases were malignant lesions, and 66 cases were benign lesions. The sensitivity, specificity, positive, accuracy and negative predictive values of BI-RADS 3 and 4 lesions were 87.0%, 79.7%, 82.8%, 75.8% and 89.4%, respectively. After adjustment with sonoelastography, the values were changed to 95.1%, 94.0%, 94.5%, 93.5% and 94.5%, respectively. After adjustment with the combination method, the area under ROC curve in BI-RADS classification was 0.945, which was significantly higher than that(0.826) before the adjustment(Z=2.63, P<0.05). Conclusions: Sonoelastography can improve the detection rate of malignant lesions in BI-RADS 3. It also reduces the need for biopsy for BI-RADS 4 lesions.
关键词
乳腺疾病；超声检查 /
乳房
Key words
Breast diseases /
Ultrasonography, mammary
中图分类号：
Ｒ737.9
Ｒ655.8
Ｒ445.1
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