钼靶与超声BI-RADS分类对乳腺浸润性导管癌的诊断一致性分析

目的：比较钼靶与超声乳腺影像数据报告系统（ BI-RADS）分类对乳腺浸润性导管癌的诊断一致性。方法回顾性分析165例经病理活检或手术病理诊断为乳腺浸润性导管癌（ IDC）患者的钼靶及超声影像资料，采用Kappa分析两种检查BI-RADS分类的结果。结果两种检查方法BI-RADS分类完全一致者109例（66％）。超声检查BI-RADS分类高于钼靶检查者21例（13％），钼靶检查BI-RADS分类高于超声检查者14例（8％）。两种检查方法BI-RADS分类4～5类结果总体一致性中等（Kappa值为0．63），4类检查结果一致性低（Kappa值为0．37），5类检查结果一致性高（Kappa值为0．78）。结论钼靶及超声检查BI-RADS分类诊断乳腺浸润性导管癌各有优势及局限性，对BI-RADS分类提示为4类的病变应同时参考以上两种检查方法的诊断结果以提高乳腺浸润性导管癌的诊断率。

Consistency of BI-RADS of mammography and color doppler ultrasonography in diagnosis of infiltrating ductal carcinoma

Objective To analyze the consistency of breast imaging reporting and data system (BI-RADS) of mammography (MAM) and color doppler ultrasonography ( CDU) in diagnosis of infiltrating ductal carcinoma ( IDC) .Methods A retrospective analysis was conducted on MAM and CDU data of 165 cases diagnosed with IDC by pathology biopsy or surgery.Kappa analysis was used to evaluate the BI-RADS category of two methods.Results There were 109 (66%) cases with consistent BI-RADS categories of MAM and CDU.There were 21 (13%) cases with higher BI-RADS categories of CDU than MAM, while 14 (8%) cases with higher BI-RADS categories of MAM than CDU.The general consistency of BI-RADS category 4 and 5 of two methods was moderate (Kappa=0.63).There was lower consistency in BI-RADS category 4 (Kappa=0.37) but higher consistency of BI-RADS category 5 (Kappa=0.78).Conclusion The BI-RADS category of MAM and CDU examination has its own advantages and limitations in diagnosis of IDC.For cases of category 4 in BI-RADS, combing two examinations should be referred so as to improve the detection rate of IDC.