摘要
目的遵循美国放射协会制定的乳腺影像学报告和数据系统（ACR BI-RADs）对乳腺病变的分级标准，观察分为3级病变组中满足此标准的例数，同时评价几种临床因素对BI—RADS分级的影响。方法对超声检查最初分为BI—RADS3级病变的487例乳腺肿块患者的声像图特征进行回顾分析。总结最初的超声表现，且对几种临床中可能影响乳腺病变分级的因素，包括患者年龄、病灶的多发性、是否可以扪及、超声医生的经验以及病灶的大小进行评价。结果487例病例中，479例（98．36％）为良性，8例（1．64％）为恶性。203例（41．68％）（包括8例恶性病灶）经回顾分析，按BI—RADS分级标准再评估为4级。如在最初超声检查分析时，严格按照分级标准，活检阳性率仅3．94％（8／203），而96．06％（195／203）不需要进行活检。年龄40岁以上和病灶多发性再评估为4级的频率更高（分别P=0．008，P=0．006）。而病灶是否可以扪及、病灶大小及医生的经验对再评估结果影响的差异则无显著统计学意义。结论病灶的多发性和年龄对于分为3级病变再分级有明显的影响。
Objective To investigate how many probably benign lesions on ultrasound（US） fulfilled the published criteria and to evaluate how clinical and personal factors influenced the categorization of breast lesions. Methods A total of 487 lesions in 487 women with more than 12 months follow-up after the initial category 3 assessment on US were included. The initial US images were retrospectively reviewed according to previously published criteria, and evaluated several factors that could influence the characterization of breast lesions in clinical practice such as age, multiplicity, palpability, radiologist＇s experience, and lesion size. Results Of 487 lesions,479 （98. 36%） were benign and 8 （1.64%） were malignant. Of 487 lesions, 203（41.68%） including 8 malignancies were reassessed as category 4. If strict criteria had been applied at initial US examination,the positive biopsy rate would have been only 3.94% （8/203） and 96.06% （195 of 203） biopsies would have been unnecessary. Lesions in women 40 years or older and multiple lesions were more frequently reassessed as category 4 （ P = 0.008 and P = 0.006, respectively）. The presence of palpability,lesion size, and the radiologist＇s experience did not significantly influence the categorization of breast lesions on US. Of 487 probably benign lesions,41.68% could be classified as category 4 lesions when strict criteria were applied in initial practice. Conclusions The multiplicity of the lesion and the patient＇ s age were found to have a significant influence on the classifcation of probably benign solid masses.
出处
《中华超声影像学杂志》
CSCD
北大核心
2011年第3期230-233,共4页
Chinese Journal of Ultrasonography
基金
国家自然科学基金（30900371,30970752）
