【摘要】 目的探讨超声BI-RADS分类误诊乳腺导管内原位癌(DCIS)的原因。方法回顾性分析经病理证实的487例乳腺导管上皮内瘤变(DIN)(包括447例DCIS及40例良性DIN)的超声表现及超声BI-RADS分类诊断结果。结果超声BI-RADS分类诊断DCIS的准确率、敏感度和特异度分别为75.15%(366/487)、76.73%(343/447)和57.50%(23/40);诊断Ⅱ型DIN的准确率明显低于Ⅲ型和Ⅳ型(χ2=27.189,P<0.001)。伴发钙化灶见于54.36%(243/447)的DCIS,明显高于良性DIN(5/40,12.50%),差异有统计学意义(χ2=25.747,P<0.001)。超声BI-RADS分类对于不伴发超声可见钙化的DCIS的误诊率为33.82%(69/204),明显高于伴发钙化者(35/243,14.40%),差异有统计学意义(χ2=23.428,P<0.001)。结论病灶长径<10mm或声像图中未见实质性肿物及钙化是超声BI-RADS分类漏诊和误诊DCIS的主要原因。更多还原

【Abstract】 Objective To explore the causes of US BI-RADS misdiagnosis of breast ductal carcinoma in situ(DCIS).Methods Totally 487 patients with ductal intraepithelial neoplasia(DIN) proved by pathologies were reviewed,including 447 DCIS and 40 benign DIN.The ultrasonic manifestation and US BI-RADS category were analyzed.Results The accuracy,sensitivity and specificity of US BI-RADS to identify DCIS was 75.15%(366/487),76.73%(343/447) and 57.5%(23/40),respectively.The diagnostic accuracy of type Ⅱ was significantly lower than that of type Ⅲ and Ⅳ(χ2=27.189,P<0.001).Calcifications were observed in 54.36%(243/447) DCIS,significantly higher than benign DIN(5/40,12.50%,χ2=25.747,P<0.001).The misdiagnosis rate of DCIS without detectable calcifications was 33.82%(69/204),significantly higher than that of DCIS with calcifications(35/243,14.40%,χ2=23.428,P<0.001).Conclusion The main causes of DCIS missed and misdiagnosed with US BI-RADS include length smaller than 10 mm,without solid masses nor ultrasonic detectable calcifications.更多还原