乳腺超声影像报告数据系统对超声引导下乳腺穿刺活检的临床应用价值

目的探讨乳腺超声影像报告数据系统(BI-RADS)分级对超声引导下乳腺穿刺活检的临床应用价值。方法 190例超声评价为BI-RADS 3、4、5级的乳腺病变患者,结合穿刺活检术后病理结果,分析BI-RADS分级的敏感度、特异度、准确度、阳性和阴性预测值,以及各分级的阳性预测值。结果 190例穿刺活检病理结果:良性病变105例,恶性病变85例。BI-RADS分级的敏感度、特异度、准确度、阳性及阴性预测值分别为91.8%、68.5%、78.9%、70.3%、91.1%。3级、4a级、4b级、4c级和5级的PPV值分别为0、14.6%、41.7%、72.5%、97.1%,各级别之间比较均有统计学差异(P<0.05)。结论 BI-RADS分级对乳腺病灶具有良好的诊断与鉴别诊断的能力,对超声引导下穿刺具有重要的指导意义。

Clinical Application Value of Breast Imaging Reporting and Data System in Ultrasound-guided Breast Aspiration Biopsy

Objective To discuss the clinical application value of breast imaging reporting and data system （BI - RADS） in ultra- sound-guided breast aspiration biopsy. Methods 190 cases of breast lesions patients were diagnosed as BI - RADS categories 3, 4, 5 by ultrasound. Combined with the histopathological results, the sensitivity, specificity, diagnostic accuracy, positive predictive value （PPV） and negative predictive value （NPV） for BI- RADS classification of benign and malignant breast lesions were analyzed. Re- suits In all of 190 lesions, 105 were confirmed benign and 85 were confirmed malignant by histopathology. The sensitivity, specifici- ty, PPV, N PV and accuracy of BI - RADS category were 91.8 %, 68.5 %, 78.9%, 70.3 % and 91.1%. All of the category 3 were benign by histopathology. The PPV ofBI - RADS category 4a, 4b, 4c, 5 were 14.6% , 41.7% ,72.5% and 97.1%, respective- ly, with statistically significant difference between the categories （ P 〈 0.05）. Conclusiom The BI - RADS classification has high clinical application value in the diagnosis and differential diagnosis of benign and malignant breast lesions, and it has important guiding value in ultrasound- guided aspiration biopsy of breast lesions.