CAJ | 학술논문

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。
목적：탐토초성유선영상보고화수거계통(BI-RADS)분급재유선소종괴림상진단중적응용개치。방법수집2011년5월지2013년12월간우아원외과행수술치료적113례유선소종괴(장경≤2 cm)고빈다보륵채색초성BI-RADS분급자료，비교BI-RADS 3~5급간적병조재초성특정상적차이，병분석기여병리진단간적관계。결과 BI-RADS 3~5급환자공99례。술후병리증실，21례BI-RADS 3급병조중량성종류20례，악성종류1례；41례BI-RADS 4급병조중량성종류10례，악성종류31례；37례BI-RADS 5급병조중량성종류3례，악성종류34례。불동분급병변재병조변연、변계、회성、주위조직개변、병조내혈관생성、혈류조력지수간차이균유통계학의의(P<0.05)。초성BI-RADS분급진단유선악성종류적양성예측치위83.33%、령민도위98.48%、특이도위60.61%、ROC곡선하면적위0.901。결론초성BI-RADS분급진단유선악성소종괴적준학성교고，재유선악성종류적조기진단화치료지도중구유중요적림상응용개치。
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.