乳腺X线摄影BI-RADS 0级诊断的分析探究

目的：对乳腺影像报告和数据系统BI-RADS 0级诊断的成因进行探索。方法收集我院2012年10月～2013年5月期间，乳腺摄影BI-RADS诊断为0级的女性患者53位，0级病灶共55例，回顾性分析此类病灶的影像学表现并统计各种表现中恶性病变所占比例。结果诊断为BI-RADS 0级的病灶均出现在致密型（33例）或混合型腺体（22例）中，无脂肪型腺体。乳腺摄影BI-RADS 0级病灶的常见影像表现有：①腺体局部结构异常（不对称致密或结构扭曲紊乱）20例；②边界不清的可疑结节影28例；③可疑钙化灶28例。各种影像可单独或合并存在，恶性病变所占比例由高到低分别为：仅表现为可疑钙化者57．1％（4/7），可疑结节伴可疑钙化者27．3％（3/11），腺体局部结构异常伴可疑钙化者20％（2/10），仅表现为腺体局部结构异常者10％（1/10），仅表现为可疑结节者5．9％（1/17）。结论由于各种主客观原因，乳腺摄影的BI-RADS 0级诊断无法避免。对于致密或混合型腺体，需要特别注意上述BI-RADS 0级病灶的常见影像表现，尤其是可疑钙化灶的存在。

Analytical study of the diagnosis of BI-RADS grade 0 on mammography

Objective To analyze the factors influencing the diagnosis of BI-RADS grade 0 on mammography .Methods 55 lesions with the diagnosis of BI-RADS grade 0 on mammography in 53 patients were enrolled in our study during the peroid from October 2012 to May 2013 .The lesions’ features were retrospectively analyzed ,and the malignent rates of each feature were calculated .Results All of the lesions with the diagnosis of BI-RADS grade 0 on mammography were found in the breast tissue of dense type （33 cases） or mixed type （22 cases） ,rather than the fatty type .The common find-ings of lesions with the diagnosis of BI-RADS grade 0 were showed as follows ：① Focal gland abnormality （asymmetric density or gland architectural distortion） in 20 cases ;② suspicious mass or nodule with obscure boundary in 28 cases ;③suspicious calcification in 28 cases .All the signs could be found alone or combined with others ,and the malignant rates of all the signs were listed respectively as follows ：suspicious calcifications alone was 57 .1% （4/7） ,suspicious mass or nod-ule with calcifications 27 .3% （3/11） ,Focal gland abnormality with calcifications 20% （2/10） ,Focal gland abnormality a-lone 10% （1/10） ,and suspicious mass or nodule alone 5 .9% （1/17） .Conclusion The diagnosis of BI-RADS grade 0 on mammography could hardly be avoided because of various objective or subjective reasons .The common findings in the breast tissue of dense or mixed type ,which were mentioned above ,especially suspicious calcifications ,shoud be paid atle-ntion .