Kim Eun-Kyung, Ko Kyung Hee, Oh Ki Keun, Kwak Jin Young, You Jai Kyung, Kim Min Jung, Park Byoung-Woo
Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 134, Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea.
AJR Am J Roentgenol. 2008 May;190(5):1209-15. doi: 10.2214/AJR.07.3259.
The objective of our study was to report the results of classification of sonographic findings according to BI-RADS and to calculate the positive predictive value (PPV) for each BI-RADS assessment category.
We prospectively classified 4,668 breast sonograms according to BI-RADS final assessment category. Suspicious sonographic findings were divided into major and minor suspicious findings. Category 1 was normal and category 2 was a benign finding such as cyst or nodule with uniform and intense hyperechogenicity. A nodule neither category 2 nor category 4 or 5 was defined as category 3. A nodule with one or more suspicious findings, not category 5, was defined as category 4. A nodule with two or more major suspicious findings was defined as category 5.
Of the 4,668 cases, 321 cases failed to undergo follow-up of at least 1 year. The PPV was 0.1% in category 1 (3/2,191), 0% in category 2 (0/773), 0.8% in category 3 (6/737), 31.1% in category 4 (161/519), and 96.9% in category 5 (123/127). In palpable lesions (n = 751), the PPV was 2.2% in category 1 (2/93), 0.9% in category 3 (2/217), 54% in category 4 (107/198), and 98% in category 5 (98/100). In nonpalpable lesions (n = 3,596), the PPV was 0.05% in category 1 (1/2,098), 0.8% in category 3 (4/520), 16.8% in category 4 (54/321), and 92.6% in category 5 (25/27).
As with mammography, placing sonographic lesions into BI-RADS categories is useful for predicting the presence of malignancy.
本研究的目的是报告根据美国放射学会（ACR）乳腺影像报告和数据系统（BI-RADS）对超声检查结果进行分类的结果，并计算每个BI-RADS评估类别的阳性预测值（PPV）。
我们根据BI-RADS最终评估类别对4668例乳腺超声检查进行前瞻性分类。可疑超声检查结果分为主要和次要可疑结果。1类为正常，2类为良性发现，如囊肿或具有均匀且强烈高回声性的结节。既不属于2类也不属于4类或5类的结节定义为3类。有一个或多个可疑结果（非5类）的结节定义为4类。有两个或更多主要可疑结果的结节定义为5类。
在4668例病例中，321例未接受至少1年的随访。1类的PPV为0.1%（3/2191），2类为0%（0/773），3类为0.8%（6/737），4类为31.1%（161/519），5类为96.9%（123/127）。在可触及病变（n = 751）中，1类的PPV为2.2%（2/93），3类为0.9%（2/217），4类为54%（107/198），5类为98%（98/100）。在不可触及病变（n = 3596）中，1类的PPV为0.05%（1/2098），3类为0.8%（4/520），4类为16.8%（54/321），5类为92.6%（25/27）。
与乳腺X线摄影一样，将超声病变分类为BI-RADS类别有助于预测恶性肿瘤的存在。
