【摘要】 目的：探究BI-RADS 3及4A类乳腺结节的超声图像特征与乳腺癌的关系，并提出一项指导BI-RADS 3类及4A类乳腺结节分类的新临床决策。方法：收集608例乳腺结节患者的病历资料（652个BI-RADS 3类及4A类乳腺结节），回顾性分析其超声图像特征与乳腺癌的相关性。结果：通过多因素Logistic回归分析显示，患者年龄≥45岁、结节呈圆形、边缘模糊、边缘毛刺状及内部血流信号与乳腺恶性肿瘤的发生显著相关（均P<0.05）。结论：提出一项新的临床决策，即当观察到以下特征中的至少两项时，患者应接受诊断性活检（BI-RADS 4A类）而非短期随访（BI-RADS 3类）：患者年龄≥45岁、结节呈圆形、边缘不清晰（模糊或毛刺状）及内部血流信号。更多还原

【Abstract】 To investigate the association between ultrasound image characteristic s of BI-RADS 3 and 4A breast lesions and breast cancers,and to propose a new clinical decision rule to guide the classification of BI-RADS 3 and 4A breast lesions.Methods:The medical records of608 patients(652 BI-RADS 3 and 4A breast lesions) were reviewed,and the association between ultrasound image characteristics and breast cancer was analyzed retrospectively.Results:Multivariate logistic regression analysis showed that patient’ s age≥45 years,round shape of mass,non-circumscribed,indistinct margin pon-circumscribed,spic ulated margin and internal va s cularitywere signific antly associated with breast malignancy(all P<0.05).Conclusion:A new clinic al decision rule is proposed,that is a patient should undergo a diagnostic biopsy(BI-RADS 4A) instead of short time follow-up(BI-RADS 3),under the circumstance that at least two of the following characteristics are observed:the patient is 45 years or older,round shape of mass,non-circumscribed(indistinct or spic ulated)margin and internal vascularity.更多还原