声脉冲辐射力技术结合BIRADS分类在乳腺实性肿块鉴别诊断中的应用价值

目的:探讨声脉冲辐射力技术（ARFI）结合超声BIRADS分类在乳腺实性肿块良恶性鉴别中的应用价值。方法:对来我院检查诊断为乳腺实性肿块的82位患者，进行ARFI弹性成像和BIRADS分级，以病理结果为金标准，分别对ARFI结合BIRADS诊断肿块良恶性和单一运用ARFI及BIRADS诊断乳腺肿块良恶性的准确性进行统计学分析。结果:ARFI联合BIRADS分类诊断乳腺实性肿块良恶性的特异性、灵敏度、阳性预测值、阴性预测值、准确性各为96%、98.8%、96%、98.8%、98.1%，Kappa值为0.948，单用ARFI诊断乳腺实性肿块良恶性的特异性、灵敏度、阳性预测值、阴性预测值、准确性各为88%、96.3%、88%、96.3%、94.3%，Kappa值为0.843。单用BIRADS分类法诊断乳腺实性肿块良恶性的特异性、灵敏度、阳性预测值、阴性预测值、准确性各为84%、95.1%、84%、95.1%、92.5%，Kappa值为0.791。ARFI联合BIRADS分类诊断效能与较单独运用ARFI及BIRADS相比，差异有统计学意义（P＜0.05）。结论:AFRI联合BIRADS分类诊断肿块良恶性能提高诊断的准确性，值得推广。

The application value of acoustic pulse radiative power technology combined with BIRADS in the differential diagnosis of mammary tumors

Objective:To examine the application value of acoustic pulse radiative technology (ARFI) and ultrasonic BIRADS classification in benign and malignant breast tumors.Methods:One hundred and six breast lesions in 82 women were evaluated with ultrasonography using ARFI and BIRADS.Pathologic results of all lesions were available.The obtained data was analyzed using an appropriate statistical test.Results:The specificity,sensitivity,positive predictive value,negative predictive value and accuracy were 96%,98.8%,96%,98.8% and 98.1% respectively when using AFRI combined with BIRADS for the diagnosis of mammary tumors.The Kappa value was 0.948.The specificity,sensitivity,positive predictive value,negative predictive value and accuracy were 88%,96.3%,88%,96.3% and 94.3%respectively,with ARFI for the diagnosis of mammary tumors respectively,and the Kappa value was 0.843.The specificity,sensitivity,positive predictive value,negative predictive value and accuracy of the diagnosis of benign malignancy were 84%,95.1%,84%,95.1%,92.5% respectively,with BIRADS for the diagnosis of mammary tumors respectively and the Kappa value of 0.791.The diagnostic efficacy of ARFI combined with BIRADS classification was statistically significant compared with the use of ARFI and BIRADS alone.Conclusion:The accuracy of diagnosis for the mammary tumor can be improved by using ARFI combined with BIRADS,which is worth for popularizing.