自动乳腺全容积成像对BI-RADS 4类肿块二次评估的诊断价值

发布时间：2018-04-27 19:40

本文选题：自动乳腺全容积成像 + 乳腺肿块　；参考：《广东医学》2017年22期

【摘要】：目的研究自动乳腺全容积成像(ABVS)技术对BI-RADS 4类肿块二次评估的诊断价值。方法选取278例常规超声诊断为BI-RADS 4类的乳腺肿块,再次进行ABVS检查,获得肿块新增冠状面三维容积信息,再次对肿块进行分类,与手术病理结果比较。结果 278个乳腺肿块,210个为良性病灶,68个为恶性病灶。ABVS对诊断乳腺4a类肿块的恶性可能性为4%(6/155),4b类为40%(34/84),4c类为72%(28/39)。以BIRADS 4a和4b作为良恶性肿块截断点,联合ABVS及单纯常规超声对乳腺癌的诊断灵敏度、特异度、准确度、阳性及阴性预测值分别为91.2%vs 72.0%,70.9%vs 71.4%,75.9%vs 71.6%,50.4%vs 45.0%,96.1%vs 88.7%,联合ABVS的灵敏度及阴性预测值高于常规超声,差异有统计学意义(P0.05)。结论 ABVS技术提高了BIRADS 4类肿块亚分类的准确性及良恶性的鉴别诊断能力,将乳腺超声检查技术推向更完善、更规范、更智能化的方向发展。
[Abstract]:Objective to study the diagnostic value of automatic full volume mammography (ABVS) in the secondary evaluation of BI-RADS type 4 masses. Methods two hundred and eighty-eight cases of breast masses diagnosed as BI-RADS type 4 by conventional ultrasound were examined by ABVS again. The new coronal volume information was obtained and the masses were classified again. The results were compared with the results of operation and pathology. Results 278 breast masses, 210 benign lesions and 68 malignant lesions. The malignant probability of ABVS in the diagnosis of 4a breast masses was 46 / 155 / 4b, 40 / 34 / 84 / 4c and 72 / 28 / 39 / 39 respectively. Using BIRADS 4a and 4b as cutoff points of benign and malignant masses, combined with ABVS and conventional ultrasound, the diagnostic sensitivity, specificity and accuracy of breast cancer were evaluated. The positive and negative predictive values were 72.0 / 70.9 / 71.4 / 75.9 / 71.4 / 75.9 / 71.62 / 71.The sensitivity and negative predictive value of ABVS combined with ABVS were significantly higher than those of conventional ultrasound (P 0.05), and the positive and negative predictive values were 72.9% vs 71.6% and 50.4% vs 45.0% and 96.1% vs 88.7 respectively. the sensitivity and negative predictive value of combined ABVS were significantly higher than those of conventional ultrasound (P 0.05). Conclusion ABVS technique can improve the accuracy of subclassification and the ability of differential diagnosis of benign and malignant tumors in BIRADS 4 types, and promote the development of breast ultrasound examination in a more perfect, standardized and intelligent direction.
【作者单位】：深圳市宝安区人民医院超声医学中心;深圳市宝安区人民医院介入科;广州医科大学附属第三医院超声医学科;
【基金】：深圳市宝安区科技计划社会公益(医疗卫生类)项目(编号:2015055)
【分类号】：R445.1;R737.9

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