作　　者： (肖静）; (董洋）; (张心茹）; (郭丙成）; (刘鲲）;

机构地区： 山东省济宁市第一人民医院超声科,山东济宁272011

出　　处： 《中国临床医学影像杂志》 2017年第8期553-555,563,共4页

摘　　要： 目的 :探讨超声弹性成像对BI-RADS 3、4级乳腺病变的临床诊断价值。方法 :选择106例患者128个BI-RADS3、4级病灶,联合弹性成像评分法对其进行调整,并与术后病理结果进行对照,采用受试者工作(ROC)曲线评价两者联合应用对乳腺病变的诊断价值。结果:128个病灶中,恶性病灶62个,良性病灶66个。调整前BI-RADS分类对恶性肿块诊断的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为87.0%、79.7%、82.8%、75.8%和89.4%;联合弹性成像调整后的BI-RADS分类对恶性肿块诊断的敏感度、特异度、准确率、阳性预测值和阴性预测值分别为95.1%、94.0%、94.5%、93.5%和94.5%。调整后的BI-RADS分类的ROC曲线下面积为0.945,明显高于调整前的0.826(Z=2.63,P<0.05)。结论:超声弹性成像能够提高BIRADS 3级病变中恶性病变的检出率,能够减少BI-RADS 4级病变中不必要的活检。 Objective： To explore the diagnostic value of sonoelastography on BI-RADS category 3 and 4 breast lesions. Methods： One hundred and twenty eight breast lesions in 106 women which were classified as BI-RADS category 3 and 4 were examined with ultrasound and sonoelastography. Sonoelastography was used to adjust the BI-RADS classification. The re-sults were further compared with those of postoperative pathology. The receiver operating characteristic （ROC） curve was em-ployed to evaluate the combined use on breast lesions. Results： Among the 128 breast lesions, 62 cases were malignant le-sions, and 66 cases were benign lesions. The sensitivity, specificity, positive, accuracy and negative predictive values of BI-RADS 3 and 4 lesions were 87.0%, 79.7%, 82.8%, 75.8% and 89.4%, respectively. After adjustment with sonoelastography, the values were changed to 95.1%, 94.0%, 94.5%, 93.5% and 94.5%, respectively. After adjustment with the combination method, the area under ROC curve in BI-RADS classification was 0.945, which was significantly higher than that （0.826） be-fore the adjustment（Z=2.63, P〈0.05）. Conclusions： Sonoelastography can improve the detection rate of malignant lesions in BI-RADS 3. It also reduces the need for biopsy for BI-RADS 4 lesions.

关 键 词： 乳腺疾病 超声检查 乳房