CAJ | 학술논문

目的：探讨超声乳腺影像报告及数据系统（BI - RADS）和应变比值对于乳腺结节的诊断价值。方法282例乳腺结节，通过超声弹性成像获得周围组织与乳腺结节的应变比值。以病理结果为金标准，应用受试者工作特征曲线，评价常规超声 BI - RADS 及应变比值（SR）鉴别乳腺结节良恶性的价值。结果282例乳腺结节包括79例恶性结节及203例良性结节。常规超声 BI - RADS 诊断的敏感度、特异度及受试者工作特征曲线下面积为100%、16.75%及0.69（95% CI 0.63-0.74）；SR 诊断的敏感度、特异度及受试者工作特征曲线下面积为73.42%、90.15%及0.874（95%CI 0.83-0.91）。SR 的诊断价值优于常规超声 BI - RADS（ Z ＝6.357，P ﹤0.001）。以2.97作为 SR 的诊断阈值鉴别常规超声 BI - RADS 4级乳腺结节222例时，170例（170/222，76.58%）可避免活检，但漏诊21例（21/222，9.46%）。结论应变比值鉴别乳腺结节的性质临床价值优于常规超声 BI - RADS，两者结合可以减少乳腺活检的需求。
목적：탐토초성유선영상보고급수거계통（BI - RADS）화응변비치대우유선결절적진단개치。방법282례유선결절，통과초성탄성성상획득주위조직여유선결절적응변비치。이병리결과위금표준，응용수시자공작특정곡선，평개상규초성 BI - RADS 급응변비치（SR）감별유선결절량악성적개치。결과282례유선결절포괄79례악성결절급203례량성결절。상규초성 BI - RADS 진단적민감도、특이도급수시자공작특정곡선하면적위100%、16.75%급0.69（95% CI 0.63-0.74）；SR 진단적민감도、특이도급수시자공작특정곡선하면적위73.42%、90.15%급0.874（95%CI 0.83-0.91）。SR 적진단개치우우상규초성 BI - RADS（ Z ＝6.357，P ﹤0.001）。이2.97작위 SR 적진단역치감별상규초성 BI - RADS 4급유선결절222례시，170례（170/222，76.58%）가피면활검，단루진21례（21/222，9.46%）。결론응변비치감별유선결절적성질림상개치우우상규초성 BI - RADS，량자결합가이감소유선활검적수구。
Objectine To explore the diagnostic value of breast imaging reporting and data system with ultrasonology(BI - RADS - US)and strain ratio in differential diagnosis of benign and malignant breast lesions. Methods Ultrasonic elastography had been performed in 282 cases of breast lesions. Strain ratio(SR)was defined as the ratio of strain of normal surrounding tissue to strain of breast lesions. With pathologic results as the gold standard,the diagnostic value of BI - RADS - US and SR in differentiating benign and malignant breast lesions had been compared with re-ceiver - operating characteristic(ROC)curve. Results A total of 79 cases of malignant lesions and 203 cases of benign lesions were included. Di-agnostic sensitivity,specificity and area under the ROC curve of BI - RADS - US were 100% ,16. 75% and 0. 69 respectively(95% CI 0. 63 - 0. 74). The sensitivity,specificity and area under the ROC curve of SR were 73. 42% ,90. 15% and 0. 874 respectively(95% CI 0. 83 -0. 91). The area under ROC curve of SR was better than BI - RADS - US( Z = 6. 357,P ﹤ 0. 001). If the cut - off point of SR was 2. 97,222(76. 58% ) breast lesions in 170 cases with BI - RADS - US 4 could avoid biopsy,but 21 cases(21 / 222,9. 46% )were misdiagnosed. Conclusion Strain ra-tio is superior to BI - RADS - US in identification of breast lesions,a combination of these two methods can reduce the demand of breast biopsy.