| 冯冰,邹秋果,曾奕,等.超声造影模型构建在乳腺影像报告和数据系统 3~5类诊断中的应用[J].安徽医药,2021,25(6):1124-1127. |
| 超声造影模型构建在乳腺影像报告和数据系统 3~5类诊断中的应用 |
| Application of contrast-enhanced ultrasound model in diagnosis of breast BI-RADS 3~5 |
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| DOI：10.3969/j.issn.1009-6469.2021.06.015 |
| 中文关键词: 乳腺疾病 超声检查，乳房 线性模型 影像报告和数据系统 |
| 英文关键词: Breast diseases Ultrasonography, mammary Linear models Breast imaging reporting and data systern |
| 基金项目:海南省自然科学基金( 20168303) |
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| 摘要点击次数: 1494 |
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| 中文摘要: |
| 目的探讨乳腺影像报告和数据系统( BI-RADS)3~5类诊断中构建超声造影模型的临床价值。方法回顾性分析海口市中医医院、海口市人民医院、海南医学院第一附属医院 2016年 6月至 2019年 6月行乳腺超声造影检查、且 BI-RADS分类 3~5类病人共 312例的临床资料，评价超声造影模型诊断效能，比较构建前后乳腺肿物穿刺活检比例、乳腺癌确诊率及漏诊率。结果全部 1 050个病灶依据超声造影模型诊断结果进行重新分类调整后可见 BI-RADS 3类比例由 0.00%(0/1 050)增加至 23.33%(245/1 050)，4A类由 41.05%(431/1 050)降低至 21.24%(223/1 050)，4B类由 28.86%(303/1 050)降低至 12.19%(128/1 050)4C类由 12.86%(135/1 050)提高至 14.76%(155/1 050)5类由 16.67%(175/1 050)增加至 28.19%(296/1 050)。根据超声造影模，型诊断结果调整并将 BI-RADS 4A类作为阈值诊断良恶，性病变，灵敏度、特异度、准确度及约登指数分别为 93.44%，76.67%，83.09%，0.70。超声造影模型构建后根据活检阈值不同分类: BI-RADS 3类作为阈值穿刺活检比例为 88.46%(276/ 312)乳腺癌确诊率为 49.28%(136/276)漏诊率为 0.64%(2/312)； BI-RADS 4A类作为阈值，穿刺活检比例为 83.33%(260/ 312)腺癌确诊率为 49.23%(128/260)诊率为 3.21%(10/312)； BI-RADS 4B类作为阈值，穿刺活检比例为 74.36%(232/ 312)腺癌确诊率为 49.14%(114/232)诊率为 7.69%(24/312)； BI-RADS 4C类作为阈值，穿刺活检比例为 57.05%(178/ 312)，腺癌确诊率为 57.30%(102/178)，率为 11.54%(36/312)。结论乳腺良恶性病灶超声造影模型建立可以提供更有乳，漏，乳，漏，乳，漏诊，价值诊断信息，完善 BI‐RADS分类，减少不必要穿刺活检或手术风险。 |
| 英文摘要: |
| Objective To explore the clinical value of the construction of contrast-enhanced ultrasound model in the diagnosis of breast imaging report and data system (BI-RADS) classification for 3~5 of breast tumor.Methods Clinical data of 312 patients with BI-RADS 3~5 type by contrast-enhanced ultrasound were retrospectively analyzed in Haikou Hospital of Traditional Chinese Medicine,Haikou People′s Hospital and The First Affiliated Hospital of Hainan Medical Collegefrom June 2016 to June 2019. The diagnostic efficiency of contrast-enhanced ultrasound model were evaluated, the proportion of breast biopsy, the diagnostic rate of breast cancer and the long-term incidence of breast cancer before and after construction were compared.Results All 1 050 lesions were reclassified and adjusted according to the diagnostic results of contrast-enhanced ultrasound model. The proportion of BI-RADS in 3 type was increasedfrom 0.00% (0/1 050) to 23.33% (245/1 050); 4A type was decreased from 41.05% (431/1 050) to 21.24% (223/1 050), 4B type was decreased from 28.86% (303/1 050) to 12.19% (128/1 050), and 4C type was increased from 12.86% (135/1 050) to 14.76% (155/1 050),5 type was increased from 16.67% (175/1 050) to 28.19% (296/1 050). The sensitivity, specificity, accuracy and Jordan index of BIRADS 4A as threshold were 93.44%, 76.67%, 83.67%, 83.09%, and 0.70 respectively, according to the diagnostic results of contrast-enhanced ultrasound model. After the establishment of contrast-enhanced ultrasound model, the proportion of puncture biopsy was88.46% (276/312), the diagnostic rate of breast cancer was 49.28% (136/276) , the missed diagnosis rate was 0.64% (2/312) with BIRADS 3 type as threshold; and the proportion of puncture biopsy was 83.33% (260/312), the diagnostic rate of breast cancer was49.23% (128/260), the missed diagnosis rate was 3.21% (10/312) with BI-RADS 4A as threshold; and the proportion of puncture biopsy was 74.36% (232/312), the diagnostic rate of breast cancer was 49.14% (114/232), the missed diagnosis rate was 7.69% (24/312) withBI-RADS 4B as threshold; and the proportion of puncture biopsy was 57.05% (178/312), the diagnostic rate of breast cancer was57.30% (102/178), the missed diagnosis rate was 11.54% (36/312) with BI-RADS 4C as threshold.Conclusion The establishment of contrast-enhanced ultrasound model of breast benign and malignant lesions can provide more valuable diagnostic information, improve BI-RADS classification, and reduce the risk of unnecessary biopsy or surgery. |
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