Gao Jun-xi, Yu Xiao-qin, Yao Lan-hui
Department of Ultrasound, the First Affiliated Hospital of Xingjiang Medical University, Urumqi 830054, China.
Zhonghua Zhong Liu Za Zhi. 2011 Jun;33(6):465-9.
To explore the value of BI-RADS ultrasonic scores of direct and indirect ultrasonographic signs in diagnosis of solid breast lesions.
Reference to the standard BI-RADS score, ultrasonic scores of direct and indirect ultrasonographic signs of 132 solid breast lesions were assigned, and were compared with pathological results.
By the direct signs of breast lesions (aspect ratio, shape, border, internal echo, posterior echo, flow grade, sand-like calcification) and indirect signs (changes in local skin thickness, Cooper ligament changes, axillary lymph nodes, depth of reinforcement membrane changes, mass changes in the surrounding burr), the integral from the total scores in benign and malignant breast masses showed a statistically significant difference. The total score of malignant lesions (8.94 ± 2.85) was significantly higher than that of benign tumors (3.09 ± 1.97, P < 0.05). Except skin thickness, all the remaining scores of the signs of benign and malignant breast tumors showed a significant difference between the two groups (P < 0.05). By receiver operating curve (ROC) analysis, the best critical value of the total score of direct signs was ≥ 4, with a sensitivity and specificity of 0.84 and 0.93, respectively, in distinguishing breast carcinoma from benign lesions. The best critical value of the total score of indirect signs was ≥ 1, with a sensitivity and specificity of 0.82 and 0.74, respectively. The critical value of the combination of the direct and indirect signs was ≥ 5 in differential diagnosis of malignant and benign lesions, with a sensitivity and specificity value of 0.88 and 0.90, respectively.
The assignment score to the ultrasound characteristics of the direct and indirect signs of solid breast lesions can make a more objective diagnosis, yet it is a simple, effective, comprehensive and semi-quantitative analysis method.
探讨乳腺实性病变直接和间接超声征象的BI-RADS超声评分在诊断中的价值。
参照BI-RADS标准评分，对132例乳腺实性病变的直接和间接超声征象进行评分，并与病理结果进行比较。
通过乳腺病变的直接征象（纵横比、形态、边界、内部回声、后方回声、血流分级、砂粒样钙化）和间接征象（局部皮肤厚度改变、Cooper韧带改变、腋窝淋巴结、强化膜深度改变、周围毛刺状肿块改变），乳腺良恶性肿块的总积分差异有统计学意义。恶性病变的总积分（8.94±2.85）明显高于良性肿瘤（3.09±1.97，P<0.05）。除皮肤厚度外，乳腺良恶性肿瘤征象的其余各项评分两组间差异均有统计学意义（P<0.05）。通过受试者操作特征曲线（ROC）分析，直接征象总评分的最佳临界值为≥4，在鉴别乳腺癌与良性病变时，敏感性和特异性分别为0.84和0.93。间接征象总评分的最佳临界值为≥1，敏感性和特异性分别为0.82和0.74。直接和间接征象联合的临界值在鉴别良恶性病变时为≥5，敏感性和特异性值分别为0.88和0.90。
对乳腺实性病变直接和间接征象的超声特征进行评分可做出更客观的诊断，是一种简单、有效、全面的半定量分析方法。
