【摘要】 目的探讨乳腺超声影像报告数据系统(BI-RADS)对乳腺病灶诊断和治疗的应用价值。方法 262例超声评价为BI-RADS 3、4、5级的乳腺病变患者,3级及部分4a级行Mammotome切除活检(US-MEB),其余行超声引导下穿刺活检,分析BI-RADS分级的敏感度、特异度、准确度、阳性预测值(PPV)和阴性预测值(NPV),以及各分级的PPV。结果病理结果:良性病变166例,恶性病变96例。BI-RADS分级的敏感度、特异度、准确度、PPV及NPV分别为91.7%、71.7%、79.0%、65.2%、93.7%。分为3、4a、4b、4c级和5级的PPV值分别为1.4%、12.7%、39.2%、70.2%、94.6%,随着分类级别的增高,PPV逐渐增高,各级别之间比较均有统计学差异(P<0.05)。结论 BI-RADS分级对乳腺病灶的诊治具有重要的指导意义。3级病灶可以短期随访,或应用US-MEB术治疗;4a级病灶恶性程度小,一部分可行US-MEB术达到诊断和治疗的目的;4b、4c、5级病灶应穿刺活检。更多还原

【Abstract】 Objective To evaluate the application value of breast imaging reporting and data system(BI-RADS) in diagnosis and excision of breast lesion.Methods 262 cases of breast lesions were diagnosed as BI-RADS categories 3,4,5 by ultrasound.All of breast lesions in category 3 and a part of breast lesions in category 4a received ultrasound-guided mammotome excisional biopsy(US-MEB).other lesions received ultrasound-guided breast biopsy.The sensitivity,specificity,accuracy,positive predictive value(PPV) and negative predictive value(NPV) for BI-RADS classification of benign and malignant breast lesions were calculated.PPV was calculated for each BI-RADS category. Results 166 were confirmed benign and 96 were confirmed malignant by histopathology.The sensitivity,specificity, accuracy,PPV and NPV of BI-RADS classification were 91.7%,71.7%,79.0%,65.2%and 93.7%.PPV of BIRADS category 3,4a,4b,4c and 5 were 1.4%,12.7%,39.2%,70.2%and 94.6%respectively,it had statistically significant difference between the categories(P<0.05).Conclusions BI-RADS classification has important guiding value in diagnosis and excision of breast lesions.The patients in category 3 should be associated with short-term follow-up or US-MEB could be performed.The malignant possibility of breast lesions in BI-RADS category 4a is very small,so it is feasible to perform US-MEB for most of breast lesions in BI-RADS category 4a.And it is necessary to perform biopsy for BI-RADS category 4b,4c and 5.更多还原