【摘要】 目的探讨超声造影检查调整乳腺BI-RADS 3、4类肿块的临床价值。方法选取我院经穿刺活检或手术病理证实的乳腺肿块患者71例(共76个肿块),良性肿块43个,恶性肿块33个,常规超声检查BI-RADS分类均为3类或4类。对其进行超声造影评分,根据评分结果重新调整乳腺BI-RADS 3、4类肿块分类,比较调整前、后BI-RADS分类对乳腺BI-RADS 3、4类肿块良恶性的诊断效能。结果 (1)76个乳腺肿块中,调整后BI-RADS分类2类7个、3类12个(3类保持不变4个)、4A类20个(3类上调2个)、4B类15个、4C类11个、5类11个,BI-RADS 4类肿块活检率降至69.8%,误诊率仅为1.6%;(2)调整前、后BI-RADS分类诊断的敏感性、特异性、准确率分别为75.8%、76.7%、76.3%和97.0%、88.4%、92.1%;ROC曲线下面积分别为0.763、0.927,差异有统计学意义(Z=3.965,P<0.05)。结论超声造影检查可通过调整BI-RADS分类提高对乳腺BI-RADS 3、4类肿块良恶性的诊断效能。更多还原

【Abstract】 ObjectiveTo explore the clinical value of contrast-enhanced ultrasound(CEUS)in adjusting breast lesions of BI-RADS category 3 and 4.MethodsA total of 71 patients with breast lesions confirmed by biopsy or pathology in our hospital were selected. There were 76 lesions,including 43 benign lesions and 33 malignant lesions. The BI-RADS classification of all lesions by routine ultrasonography were category 3 or 4,and they were scored by CEUS. The classification of breast BI-RADS category was readjusted according to the CEUS score results,and the diagnostic efficacy of the BI-RADS classification before and after adjustment for benign and malignant breast lesions of BI-RADS category 3 and 4 was compared.Results(1)Among the 76 breast lesions,there were 7 lesions in BI-RADS category 2,12 lesions in category 3(4 lesions in 3 categories remained unchanged),and 20 lesions in category 4 A(2 lesions increase in category 3),15 lesions in category 4 B,11 lesions in category 4 C,and 11 lesions in category 5 after the adjustment.The biopsy rate of lesions of BI-RADS category 4 decreased by 69.8%,and the misdiagnosis rate was only 1.6%.(2) The sensitivity,specificity,and accuracy of BI-RADS classification before and after adjustment were 75.8%,76.7%,76.3% and 97.0%,88.4%,92.1%,respectively. The areas under the ROC curve before and after adjustment were 0.763 and 0.927,respectively,the difference was statistically significant(Z=3.965,P<0.05).ConclusionCEUS can improve the diagnostic efficacy of breast lesions of BI-RADS category 3 and 4 by adjusting the BI-RADS classification.更多还原