标题：乳腺小肿块超声BI-RADS分级的临床应用价值

      作者：张方芳 1，周卫芳 2，王 琼 3，庄文洪 1
    (1.汕头市中医医院B超室，广东 汕头 515031；
2.汕头市第三医院内科，广东 汕头 515073；
3.汕头市中医医院护理部，广东 汕头 515031)

      卷次： 2015年26卷4期

      【摘要】 目的 探讨超声乳腺影像报告和数据系统(BI-RADS)分级在乳腺小肿块临床诊断中的应用价值。
方法 收集2011年5月至2013年12月间于我院外科行手术治疗的113例乳腺小肿块(长径≤2 cm)高频多普勒彩
色超声BI-RADS分级资料，比较BI-RADS 3~5级间的病灶在超声特征上的差异，并分析其与病理诊断间的关
系。结果 BI-RADS 3~5级患者共99例。术后病理证实，21例BI-RADS 3级病灶中良性肿瘤20例，恶性肿瘤1
例；41例BI-RADS 4级病灶中良性肿瘤10例，恶性肿瘤31例；37例BI-RADS 5级病灶中良性肿瘤3例，恶性肿瘤
34例。不同分级病变在病灶边缘、边界、回声、周围组织改变、病灶内血管生成、血流阻力指数间差异均有统计学
意义(P<0.05)。超声 BI-RADS分级诊断乳腺恶性肿瘤的阳性预测值为 83.33%、灵敏度为 98.48%、特异度为
60.61%、ROC曲线下面积为0.901。结论 超声BI-RADS分级诊断乳腺恶性小肿块的准确性较高，在乳腺恶性
肿瘤的早期诊断和治疗指导中具有重要的临床应用价值。

      【关键词】 超声；乳腺小肿块；BI-RADS分级；临床价值

      【中图分类号】 R445.1 【文献标识码】 A 【文章编号】 1003—6350（2015）04—0526—03


Clinical value of ultrasonic BI-RADS classification in small breast neoplasm.
ZHANG Fang-fang 1, ZHOU
Wei-fang 2, WANG Qiong 3, ZHUANG Wen-hong 1. 1. B-ultrasound Room, Shantou Hospital of Traditional Chinese
Medicine, Shantou 515031, Guangdong, CHINA; 2. Department of Internal Medicine, the Third Hospital of Shantou,
Shantou 515073, Guangdong, CHINA; 3. Department of Nursing, Shantou Hospital of Traditional Chinese Medicine,
Shantou 515031, Guangdong, CHINA

【Abstract】 Objective To investigate the clinical application of ultrasonic BI-RADS classification in small
breast neoplasm. Methods A total of 113 small breast neoplasm lesions (length≤2 cm) from May 2011 to Dec. 2013
were enrolled in the study, and their data of ultrasonic BI-RADS classification were collected. The differences of ultra-
sonic features between BI-RADS classification 3 and 5 were compared, and then the relationship between BI-RADS
classification and pathological diagnosis was analyzed. Results Ninety-nine lesions were judged in BI-RADS classi-
fication between 3 and 5. According to the postoperative pathological results, there were 20 benign tumors and 1 ma-
lignant tumor among the 21 breast lesions of BI-RADS grade 3, 10 benign tumors and 31 malignant tumor among the
41 breast lesions of BI-RADS grade 4, 3 benign tumors and 34 malignant tumor among the 37 breast lesions of
BI-RADS grade 5. Statistically significant difference was found between BI-RADS grade 3, 4, 5 in margin, lesion
boundary, posterior acoustic feature, the changes of surrounding tissue, vascularity in lesion and blood flow resistance
index (RI). The positive predictive value, sensitivity and specificity was 83.33%, 98.48% and 60.61%, respectively.
The area under receiver operating characteristic curve was 0.901. Conclusion Ultrasonic BI-RADS classification
has a high accuracy in the diagnoses of small breast neoplasm. It has a high application value in the early diagnosis
and treatment of breast malignant tumor.

      【Key words】 Ultrasound; Small breast neoplasm; BI-RADS classification; Clinical value
基金项目：2012年度汕头市医疗重点科技计划项目(编号：2012113)