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实性乳腺肿块的特征描述:超声BI-RADS分类的应用。

Solid breast mass characterisation: use of the sonographic BI-RADS classification.

作者信息

Costantini M, Belli P, Ierardi C, Franceschini G, La Torre G, Bonomo L

机构信息

Dipartimento di Bio-Immagini e Scienze Radiologiche, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, Rome, Italy.

出版信息

Radiol Med. 2007 Sep;112(6):877-94. doi: 10.1007/s11547-007-0189-6. Epub 2007 Sep 20.

Abstract

PURPOSE

The aim of this study was to assess the reliability of the sonographic Breast Imaging Reporting and Data System (BI-RADS) classification in differentiating benign from malignant breast masses.

MATERIALS AND METHODS

A total of 292 female patients with breast masses undergoing biopsy between November 2004 and March 2006 in our department were included in this study. All lesions were classified according to the sonographic BI-RADS lexicon. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the sonographic BI-RADS lexicon and PPV and NPV for each lesion category and each sonographic descriptor were calculated. The chi(2) test and the Fischer exact test were used to evaluate our results.

RESULTS

Univariate analysis showed a significant difference between malignant and benign groups with regard to morphology (p<0.001), horizontal-vertical diameter ratio<1 (p<0.002), orientation (p<0.001), noncircumscribed margins (p<0.001), echogenic halo (p<0.001), hypoechoic pattern (p=0.035), shadowing (p<0.001) and surrounding tissue alterations (p=0.001). The cumulative risk for malignancy was 64 and 10 times higher, respectively, in categories 5 and 4 than in category 3.

CONCLUSIONS

The sonographic BI-RADS lexicon is an important system for describing and classifying breast lesions.

摘要

目的

本研究旨在评估超声乳腺影像报告和数据系统(BI-RADS)分类在鉴别乳腺良恶性肿块方面的可靠性。

材料与方法

本研究纳入了2004年11月至2006年3月期间在我科接受活检的292例有乳腺肿块的女性患者。所有病变均根据超声BI-RADS词典进行分类。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),以及每个病变类别和每个超声描述符的PPV和NPV。采用卡方检验和费舍尔精确检验来评估我们的结果。

结果

单因素分析显示,恶性组和良性组在形态(p<0.001)、纵横径比<1(p<0.002)、方向(p<0.001)、边界不清(p<0.001)、回声晕(p<0.001)、低回声模式(p=0.035)、后方回声衰减(p<0.001)和周围组织改变(p=0.001)方面存在显著差异。5类和4类病变的恶性累积风险分别比3类高64倍和10倍。

结论

超声BI-RADS词典是描述和分类乳腺病变的重要系统。

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