CAJ | 학술논문

目的：探讨超声肿块特征对BI－RADS 3～5级病变的诊断价值。方法通过回顾性分析65个乳腺癌与92个乳腺良性肿块超声表现，比较两组肿块间8个超声特征包括形态不规则、边缘不光整、非平行方位、微小钙化、后方回声衰减、高回声晕、肿块内部血流、动脉血流频谱RI≥0．7，分析各超声特征敏感度、特异度、准确性。结果两组间所有8个超声特征包括形态不规则、边缘不光整、非平行方位、微小钙化、后方回声衰减、高回声晕、肿块内部血流、动脉血流频谱RI≥0．7在良、恶性鉴别中均有统计学差异（P＜0．05）。其中边缘不光整诊断乳腺癌敏感度较高（93．7％），其余7个超声特征敏感度较低，而边缘不光整诊断乳腺癌特异度较低，其余7个超声特征特异度较高，尤以微小钙化、高回声晕，对乳腺癌的诊断特异度分别为95．5％、96．8％。结论超声特征边缘不光整诊断乳腺癌敏感度较高，是筛查、随访乳腺结节鉴别其良恶性最重要的征象；形态不规则、非平行方位、微小钙化、后方回声衰减、高回声晕、肿块内部血流、动脉血流频谱RI≥0．7诊断乳腺癌特异度较高，是选择活检或手术的重要超声特征。当出现上述8个超声征象之一时，乳腺肿块倾向于BI－RADS 4B级，出现微小钙化、高回声晕或其余六项中两项征象时，应考虑BI－RADS 4C级，两项以上则考虑BI－RADS 5级。
목적：탐토초성종괴특정대BI－RADS 3～5급병변적진단개치。방법통과회고성분석65개유선암여92개유선량성종괴초성표현，비교량조종괴간8개초성특정포괄형태불규칙、변연불광정、비평행방위、미소개화、후방회성쇠감、고회성훈、종괴내부혈류、동맥혈류빈보RI≥0．7，분석각초성특정민감도、특이도、준학성。결과량조간소유8개초성특정포괄형태불규칙、변연불광정、비평행방위、미소개화、후방회성쇠감、고회성훈、종괴내부혈류、동맥혈류빈보RI≥0．7재량、악성감별중균유통계학차이（P＜0．05）。기중변연불광정진단유선암민감도교고（93．7％），기여7개초성특정민감도교저，이변연불광정진단유선암특이도교저，기여7개초성특정특이도교고，우이미소개화、고회성훈，대유선암적진단특이도분별위95．5％、96．8％。결론초성특정변연불광정진단유선암민감도교고，시사사、수방유선결절감별기량악성최중요적정상；형태불규칙、비평행방위、미소개화、후방회성쇠감、고회성훈、종괴내부혈류、동맥혈류빈보RI≥0．7진단유선암특이도교고，시선택활검혹수술적중요초성특정。당출현상술8개초성정상지일시，유선종괴경향우BI－RADS 4B급，출현미소개화、고회성훈혹기여륙항중량항정상시，응고필BI－RADS 4C급，량항이상칙고필BI－RADS 5급。
Objective To explore the diagnostic value of of Breast Imaging Reporting and Data System-Ultrasound( BI-RADS) lexi-con for category 3-5 breast lesions.Methods A retrospective analysis of the performance of 65 breast cancer and 92 benign breast lesions with ultrasound, comparing The BI-RADS-US lexicon including Irregular shape, non-circumscribed margin, non-parallel orientation, micro calcification, shadowing, echogenic halo, lesions internal flow and RI≥0.7,comparison of the sensitivity, specificity and accuracy. Results Irregular shape, non-circumscribed margin, non-parallel orientation, micro calcification, shadowing, echogenic halo, lesions internal flow and RI≥0.7 were more frequently found in malignant lesions than in benign lesions.A good sensitivity was demonstrated (93.7%) when using the non-circumscribed margin as a criterion for malignancy, and high specificity was achieved when other descrip-tors including Irregular shape, non-parallel orientation, micro calcification, shadowing, echogenic halo, lesions internal flow and RI≥0.7 were used as differentiation criteria, especially micro calcification and echogenic halo, the specificity was 95.5%, 96.8%.Conclusion Non-circumscribed margin are proved as the most valuable sign for screening malignant breast lesions.High specificity was found for Irreg-ular shape, non-parallel orientation, micro calcification, shadowing, echogenic halo, lesions internal flow and RI≥0.7, which can help biopsy and preoperative diagnosis.When breast lesion occurs one of the above BI-RADS-US lexicon tend to BI-RADS category 4B le-sions, micro calcification, echogenic halo or two of the remaining BI-RADS-US lexicon, should be BI-RADS category 4C lesions, three or more BI -RADS category 5 lesions.