Costantini Melania, Belli Paolo, Lombardi Roberta, Franceschini Gianluca, Mulè Antonino, Bonomo Lorenzo
Department of Bio-Imaging, Catholic University, Rome, Italy.
J Ultrasound Med. 2006 May;25(5):649-59; quiz 661. doi: 10.7863/jum.2006.25.5.649.
The purpose of this study was to determine the reliability of sonographic American College of Radiology Breast Imaging Reporting And Data System (BI-RADS) classification in differentiating benign from malignant breast masses.
One hundred seventy-eight breast masses studied by sonography with a known diagnosis were reviewed. All lesions were classified according to the sonographic BI-RADS lexicon. Pathologic results were compared with sonographic features. Sensitivity, specificity, accuracy, and positive predictive value (PPV) and negative predictive value (NPV) for the sonographic BI-RADS lexicon were calculated.
Twenty-six cases were assigned to class 3, 73 to class 4, and 79 to class 5. Pathologic results revealed 105 malignant and 73 benign lesions. The sonographic BI-RADS lexicon showed 71.3% accuracy, 98.1% sensitivity, 32.9% specificity, 67.8% PPV, and 92.3% NPV. The NPV for class 3 was 92.3%. The PPVs for classes 4 and 5 were 46.6% and 87.3%. Typical signs of malignancy were irregular shape, antiparallel orientation, noncircumscribed margin, echogenic halo, and decreased sound transmission. Typical signs of benignity were oval shape and circumscribed margin.
The sonographic BI-RADS lexicon is an important system for describing and classifying breast lesions.
本研究的目的是确定美国放射学会乳腺影像报告和数据系统（BI-RADS）超声分类在鉴别乳腺良恶性肿块方面的可靠性。
回顾了178个经超声检查且诊断明确的乳腺肿块。所有病变均根据超声BI-RADS词典进行分类。将病理结果与超声特征进行比较。计算超声BI-RADS词典的敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）。
26例被归类为3类，73例为4类，79例为5类。病理结果显示105例为恶性病变，73例为良性病变。超声BI-RADS词典显示准确性为71.3%，敏感性为98.1%，特异性为32.9%，PPV为67.8%，NPV为92.3%。3类的NPV为92.3%。4类和5类的PPV分别为46.6%和87.3%。恶性的典型征象为形状不规则、平行方位、边界不清、有回声晕和透声降低。良性的典型征象为椭圆形和边界清晰。
超声BI-RADS词典是描述和分类乳腺病变的重要系统。
