乳腺X线BI-RADS分类的临床应用价值-东南大学学报医学版

乳腺X线BI-RADS分类的临床应用价值

单位：1. 东南大学医学院, 江苏南京 210009;
2. 东南大学附属中大医院放射科, 江苏南京 210009

分类号：R655.8;R445.4

出版年·卷·期（页码）：2021·40·第三期（385-389）

摘要：

目的：评价乳腺X线影像报告与数据系统（BI-RADS）的临床应用价值。方法：依据BI-RADS分类标准对911例乳腺病患者共1 063个病灶进行分类，以病理结果为金标准，使用受试者工作特征（ROC）曲线分析计算BI-RADS分类对乳腺病灶及对不同表观类型病灶的诊断效能。结果：乳腺X线BI-RADS分类对乳腺病灶诊断的准确率为87.4%，敏感度为86.5%，特异度为88.5%，阳性预测值（PPV）为90.5%，阴性预测值（NPV）为83.9%，ROC曲线下面积（AUC）为0.924。乳腺X线BI-RADS分类对肿块型病灶和非肿块型病灶的AUC值分别为0.948、0.886（P<0.05）；对大肿块（直径为>2 cm）和小肿块（直径≤2 cm）的AUC分别为0.955、0.929（P<0.05）；对钙化、非对称、结构扭曲的AUC值分别为0.946、0.866、0.843（P<0.05）。结果显示BI-RADS 3、4A、4B、4C、5类病灶的恶性率分别为7.2%、25.2%、75.8%、96.9%、98.7%。结论：BI-RADS分类对乳腺病变具有较高的临床指导价值。

Objective: To evaluate the diagnostic value of the breast imaging reporting and data system(BI-RADS) in mammography. Methods: 911 patients with 1 063 breast lesions were retrospectively analyzed for mammography. Two radiologists used BI-RADS to classify enrolled lesions to five degree. Using pathology results as the gold standard, receiver operating characteristic(ROC) curve was used to evaluate the diagnostic efficiency of BI-RADS for all lesions and different phenotypes. Results: The accuracy, sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of BI-RADS to diagnose all breast lesions were 87.4%, 86.5%, 88.5%, 90.5% and 83.9% and area under curve (AUC) was 0.924. The results of diagnostic efficiency of BI-RADS for different phenotypes were as follows: in mass lesions and non-mass lesions, the diagnostic AUC were 0.948 and 0.886 (P<0.05). The diagnostic AUC for large mass (diameter>2 cm) and small mass (diameter≤2 cm) were 0.955 and 0.929(P<0.05), respectively. While the diagnostic AUC for calcification, asymmetry, architectural distortion were 0.946, 0.866, 0.843(P<0.05), respectively. In this study, the malignant rates of BI-RADS 3, 4A, 4B, 4C, 5 breast lesions were 7.2%, 25.2%, 75.8%, 96.9%, 98.7%. Conclusion: BI-RADS has a high value in diagnosis of breast diseases and provides guidance for the follow-up treatment.

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