【摘要】 目的探讨自动乳腺全容积成像(ABVS)联合乳腺影像报告和数据系统(BI-RADS)分类对常规超声恶性征象不典型(BI-RADS分类3类及4A类)乳腺癌的诊断价值。方法对常规超声BI-RADS分类3类及4A类的832例患者共876个乳腺肿块行ABVS。结合ABVS冠状位图像特点对乳腺肿块重新进行BI-RADS分类。与术后病理结果对照,比较常规超声BI-RADS分类与ABVS结合BI-RADS分类为3类、4A类肿块中恶性率的差异;并以BI-RADS分类≥4B类为恶性肿块诊断标准,评价ABVS结合BI-RADS分类诊断乳腺恶性肿块的效能。结果常规超声BI-RADS分类为3类肿块558个,恶性率4.30%(24/558),4A类肿块318个,恶性率11.01%(35/318)。结合ABVS冠状位图像特点重新分类后,3类肿块455个,恶性率0.66%(3/455);4A类肿块176个,恶性率4.55%(8/176);4B类肿块218个,恶性率14.22%(31/218);4C类肿块27个,恶性率62.96%(17/27)。ABVS结合BI-RADS分类为3类、4A类肿块的恶性率明显低于常规超声分类为3类、4A类肿块(χ~2=11.447、5.951,P=0.001、0.015)。ABVS结合BI-RADS分类对恶性肿块的诊断敏感度、特异度及准确率分别为81.36%(48/59)、75.89%(620/817)及76.26%(668/876)。结论 ABVS结合BI-RADS分类对常规超声恶性征象不典型的乳腺癌具有重要诊断价值。更多还原

【Abstract】 Objective To explore the value of automated breast volume scanner(ABVS)combined with breast imaging reporting and data system(BI-RADS)for diagnosing atypical breast cancer with untypical features diagnosed as BI-RADS 3 and 4 Atypes with conventional ultrasonography.Methods A total of 832 patients with 876 breast lesions of conventional ultrasonography classified as BI-RADS 3 and 4 A types were reexamined using ABVS.BI-RADS classification was reclassified considering the performances of coronal ABVS image and conventional ultrasonic findings.Taking pathology results as the gold standards,the malignant rates of lesions with conventional ultrasonic BI-RADS of 3 and 4 Atypes were compared with those of lesions with routine BI-RADS considering ABVS of 3 and 4 Atypes.Taken BI-RADS classification≥4 Bas the diagnostic criteria for malignant lesions,the efficacy of routine BI-RADS considering ABVS for diagnosing malignant breast mass was evaluated.Results There were 558 lesions classified as BI-RADS 3(malignant rate 4.30%[24/558])and 318 lesions classified as BI-RADS 4 A(malignant rate 11.01% [35/318]) with conventional ultrasonography.Considering with the performances of coronal ABVS image,the classifications were reclassified as 455 lesions of BI-RADS 3(malignant rate 0.66% [3/455]),176 lesions of BI-RADS 4 A(malignant rate 4.55% [8/176]),218 lesions of BI-RADS 4 B(malignant rate 14.22% [31/218])and 27 lesions of BI-RADS 4 C(malignant rate 62.96%[17/27]).The malignant rate of lesions classified as BI-RADS 3 and 4 A with routine BI-RADS considering ABVS was significantly lower than that of lesions classified as BI-RADS 3 and 4 A with conventional ultrasonography(χ~2=11.447,5.951;P=0.001,0.015).The sensitivity,specificity and accuracy of routine BI-RADS considering ABVS for diagnosing malignant breast mass was 81.36%(48/59),75.89%(620/817)and 76.26%(668/876),respectively.Conclusion Routine BI-RADS considering ABVS has great importance in diagnosis of atypical breast cancer with untypical features of conventional ultrasonography.更多还原