【摘要】 目的探讨钼靶X线与超声对乳腺影像报告与数据系统(BI-RADS)Ⅲ～Ⅳ级乳腺病变的诊断价值。方法对我院2010年1月～2012年12月经术后病理证实的100例BI-RADSⅢ～Ⅳ级女性乳腺肿块患者的钼靶X线及超声检查的资料进行回顾性分析,总结两种方法在影像学诊断中的特点。结果 100例乳腺肿块患者120个病灶,74个为BI-RADSⅢ级,良性57个,占77.03%;恶性17个,占22.97%;46个为BI-RADS IV级,良性7个,占15.22%,恶性39个,占84.78%。钼靶X线图像以片状致密影、结节状影、肿块影、钙化影以及致密模糊结节影为主要的临床表现,其阳性诊断率为77.5%,正确率为78.3%,误诊率11.7%,漏诊率10.0%;而超声图像主要液性、混合性、实质性、边界清晰或不清等局限性病变为主,其阳性诊断率为91.7%,正确率为75.0%,误诊率14.2%,漏诊率10.8%。而超声和钼靶X线联合检查,阳性诊断率为95.8%,正确率92.5%,误诊率4.2%,漏诊率3.3%。两者联合检查的阳性率以及准确率均高于二者单独检查(P<0.05);且误诊率和漏诊率明显低于单独检查(P<0.05)。结论钼靶X线联合超声检查可以互补各自的缺点,大大提高BI-RADSⅢ～Ⅳ级乳腺疾病的检出率,提高阳性诊断率,从而避免因漏诊给患者带来不利的影响。更多还原

【Abstract】 Objective To investigate the application value of breast imaging reporting and data system(BI-RADS) ⅢⅣ lesions by X-ray mammography and/or ultrasound.Methods 100 patients in our hospital from January 2010 to December 2012 with BI-RADS Ⅲ-Ⅳ lesions confirmed by pathological diagnosis were enrolled.All of them underwent clinical examination,mammography and ultrasound,summarized radiographic features of mammography and ultrasound.Results 100 patients had 120 lesions.74 BI-RADS Ⅲ,57 benign,accounting for 77.03%;vicious 17,accounting for 22.97%;46 BI-RADS Ⅳ,7 benign,accounting for 15.22%,malignant 39,accounting for 84.78%.Molybdenum target X-ray image performance to flake opacities,nodules,lumps shadow,calcification and dense fuzzy nodules,positive diagnosis was 77.5%,accuracy was 78.3%,misdiagnosis rate was 11.7%,the rate of misdiagnosis was 10.0%;ultrasound images mainly restricted lesions,fluid,mixed,materiality,the boundary clear or unclear,the positive diagnosis was 91.7%,the correct rate of 75.0%,the rate of misdiagnosis 14.2%,misdiagnosis rate of 10.8%.Ultrasound and mammography X-ray of the Joint Inspection positive diagnosis was 95.8%,accuracy rate was 92.5%,the misdiagnosis rate of 4.2%,3.3% of the rate of misdiagnosis.Joint Inspection of both positive rate and the accuracy rate is higher than the two separate checks,P < 0.05;misdiagnosis and missed diagnosis rate was significantly lower than the two separate checks(P < 0.05).Conclusion It is demonstrated that the mechanism of mammography and ultrasound imaging are different.Combination of the two approaches could improve the BI-RADS Ⅲ-Ⅳ detection rate and accuracy of differential diagnosis between benign and malignant lesion.更多还原