Stavros A T, Thickman D, Rapp C L, Dennis M A, Parker S H, Sisney G A
Radiology Imaging Associates, Englewood, CO 80110, USA.
Radiology. 1995 Jul;196(1):123-34. doi: 10.1148/radiology.196.1.7784555.
To determine whether sonography could help accurately distinguish benign solid breast nodules from indeterminate or malignant nodules and whether this distinction could be definite enough to obviate biopsy.
Seven hundred fifty sonographically solid breast nodules were prospectively classified as benign, indeterminate, or malignant. Benign nodules had no malignant characteristics and had either intense homogeneous hyperechogenicity or a thin echogenic pseudocapsule with an ellipsoid shape or fewer than four gentle lobulations. Sonographic classifications were compared with biopsy results. The sensitivity, specificity, and negative and positive predictive values of the classifications were calculated.
Benign histologic features were found in 625 (83%) lesions; malignant histologic features, in 125 (17%). Of benign lesions, 424 had been prospectively classified as benign. Two lesions classified as benign were found to be malignant at biopsy. Thus, the classification scheme had a negative predictive value of 99.5%. Of 125 malignant lesions, 123 were correctly classified as indeterminate or malignant (98.4% sensitivity).
Sonography can be used to accurately classify some solid lesions as benign, allowing imaging follow-up rather than biopsy.
确定超声检查能否有助于准确区分乳腺实性良性结节与不确定或恶性结节，以及这种区分是否足够明确以避免活检。
对750个超声检查为实性的乳腺结节进行前瞻性分类，分为良性、不确定或恶性。良性结节无恶性特征，具有强烈均匀的高回声或薄的回声伪包膜，呈椭圆形或小叶少于四个。将超声分类结果与活检结果进行比较。计算分类的敏感性、特异性、阴性和阳性预测值。
625个（83%）病变具有良性组织学特征；125个（17%）具有恶性组织学特征。在良性病变中，424个被前瞻性分类为良性。活检发现2个分类为良性的病变为恶性。因此，该分类方案的阴性预测值为99.5%。在125个恶性病变中，123个被正确分类为不确定或恶性（敏感性为98.4%）。
超声检查可用于将一些实性病变准确分类为良性，从而进行影像学随访而非活检。
