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目的分析257个常规超声乳腺影像学报告及数据系统(BI-RADS)4类乳腺肿块的自动乳腺全容积成像(ABVS)检查结果,探讨对常规超声BI-RADS4类乳腺肿块进行ABVS再评估的临床价值。方法选择行常规超声检查并采用BI-RADS分类分为BI-RADS4类的乳腺肿块257个,其中4A类135个、4B类40个、4C类82个。肿块均行ABVS检查,然后用BI-RADS再次分类。分析本组乳腺肿块常规超声、ABVS检查BI-RADS分类结果的差异。将BI-RADS4A类肿块诊断为良性肿块,BI-RADS4B和BI-RADS4C类肿块诊断为恶性肿块,以病理检查结果为金标准,计算常规超声、ABVS诊断BI-RADS4类乳腺肿块良恶性的灵敏度、特异度和准确率。结果本组肿块ABVS检查后用BI-RADS分为4A类145个、4B类27个、4C类85个。ABVS诊断为良性肿块145个、恶性肿块112个,诊断灵敏度85.71%(96/112)、特异度91.03%(132/145)、准确率88.72%(228/257)。常规超声诊断为良性肿块135个、恶性肿块122个,诊断灵敏度77.05%(94/122)、特异度88.89%(120/135)、准确率83.27%(214/257)。ABVS诊断BI-RADS4类乳腺肿块良恶性的灵敏度、特异度和诊断准确性均高于常规超声(P均<0.05)。结论对常规超声BI-RADS4类乳腺肿块行ABVS检查可以减少BI-RADS4B类诊断,提高乳腺肿块良恶性判断的准确率。
Objective To analyze the results of automatic breast total volumetric imaging (ABVS) in 257 conventional breast ultrasound imaging and data systems (BI-RADS) of four types of breast masses and to explore the clinical evaluation of ABVS re-evaluation on conventional ultrasound BI-RADS4 breast masses value. Methods 257 breast masses were divided into BI-RADS4 categories by routine ultrasound examination and BI-RADS classification, of which 135 were in category 4A, 40 in category 4B and 82 in category 4C. The masses were examined by ABVS and then reclassified using BI-RADS. Analysis of this group of conventional breast ultrasound, ABVS BI-RADS check the differences in classification results. BI-RADS4A was diagnosed as benign, BI-RADS4B and BI-RADS4C were diagnosed as malignant, and pathological examination was used as the gold standard to calculate the sensitivity of ABVS in diagnosing benign and malignant lesions of BI-RADS4. Specificity and accuracy. Results The volume of ABVS in this group was classified into 145 categories of 4A, 27 categories of 4B and 85 categories of 4C by BI-RADS. There were 145 benign and 112 malignant tumors diagnosed by ABVS. The diagnostic sensitivity was 85.71% (96/112), the specificity was 91.03% (132/145) and the accuracy was 88.72% (228/257). There were 135 benign and 122 malignant tumors diagnosed by conventional ultrasonography. The diagnostic sensitivity was 77.05% (94/122), the specificity was 88.89% (120/135) and the accuracy was 83.27% (214/257). The sensitivity, specificity and diagnostic accuracy of ABVS in the diagnosis of benign and malignant tumors of BI-RADS4 type were higher than those of conventional ultrasound (all P <0.05). Conclusion The ABVS examination of routine ultrasound BI-RADS4 breast mass can reduce the diagnostic accuracy of BI-RADS4B and improve the diagnostic accuracy of benign and malignant breast masses.