基于自动乳腺容积扫描、乳腺X线摄影及MRI的BI-RADS分类鉴别乳腺良恶性肿块

目的比较基于自动乳腺容积扫描(ABVS)、乳腺X线摄影(MMG)及MRI的BI-RADS分类鉴别乳腺良恶性肿块的价值。方法回顾性分析94例乳腺肿块患者(104个病灶)的ABVS、MMG及MRI资料,根据第五版BI-RADS标准评估肿块并进行分类。以病理结果为标准,绘制ABVS、MMG、MRI的BI-RADS分类鉴别乳腺良恶性肿块的ROC曲线,比较3种方法的AUC、敏感度和特异度差异。结果104个乳腺肿块中,良性59个(56.73%),恶性45个(43.27%)。基于ABVS与基于MRI的BI-RADS分类鉴别乳腺良恶性肿块的AUC均为0.93,差异无统计学意义(Z=0.05,P=0.96),均高于MMG(0.82)(Z=2.74、3.32,P均<0.01)。3种方法诊断的最佳截断值均为BI-RADS 4a,ABVS的敏感度(91.11%)与MRI(88.89%)差异无统计学意义(χ²=0.12,P=0.73),且均高于MMG(71.11%)(χ²=5.87、4.44,P均<0.05);ABVS、MRI及MMG的特异度分别为86.44%、89.83%及83.05%,差异均无统计学意义(P均>0.05)。结论基于ABVS、MRI的BI-RADS分类鉴别乳腺良恶性肿块的效能相当,且均高于MMG。

BI-RADS classification based on automated breast volume scanning, X-ray mammography and MRI for differentiation of benign and malignant breast masses

Objective To compare the value of breast imaging reporting and data system(BI-RADS)classification of automated breast volume scanning(ABVS),X-ray mammography(MMG)and MRI in differentiating benign and malignant breast masses.Methods Data of ABVS,MMG and MRI in 94 breast masses patients(104 lesions)were retrospectively analyzed.All masses were respectively classified with ABVS,MMG and MRI according to the fifth edition of BI-RADS.ROC curves of BI-RADS classification of ABVS,MRI and MMG in differentiating benign and malignant breast masses were drawn based on the pathological results,and AUC,sensitivity and specificity were compared among 3 methods.Results Among 104 breast lesions,59(56.73%)were benign and 45(43.27%)were malignant.AUC of BI-RADS classification based on ABVS and MRI for differentiation of benign and malignant breast masses were both 0.93(Z=0.05,P=0.96),higher than that of MMG(0.82,Z=2.74,3.32,both P<0.01).The best cut-off value of 3 methods were all BI-RADS 4a.The sensitivity of ABVS(91.11%)and MRI(88.89%)was not significantly different(χ²=0.12,P=0.73),both higher than that of MMG(71.11%,χ²=5.87,4.44,both P<0.05).The specificity of ABVS,MRI and MMG was 86.44%,89.83%and 83.05%,respectively,and there was no statistical difference in pairwise comparison(all P>0.05).Conclusion The efficacy of BI-RADS classification of ABVS and MRI for differentiating benign and malignant breast masses were comparable and both higher than that of MMG.