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目的探讨超声BI-RADS4级触诊阴性乳腺病灶的超声特点及诊断价值。方法回顾性分析102例临床触诊阴性、超声BI-RADS 4级乳腺病灶的超声特点及病理结果,评价乳腺超声对此类患者的诊断价值。结果 102个BI-RADS4级病灶中,良性肿瘤47个,恶性肿瘤55个,阳性预测值为53.9%。4A级阳性预测值为15.6%,4B级阳性预测值为56.1%,4C级阳性预测值为93.1%。形态不规则的诊断敏感性最高(89.1%),毛刺、小分叶、微钙化、后方回声衰减和Ⅱ~Ⅲ级血流对肿瘤诊断的特异性较高,分别为:95.7%、87.2%、89.4%、80.9%、87.2%。结论在BI-RADS 4级病灶中,形态不规则对乳腺癌的诊断有较高的敏感性,而毛刺、小分叶、后方回声衰减、微小钙化和Ⅱ、Ⅲ级的血流对乳腺癌的诊断有较高的特异性。
Objective To investigate the ultrasound features and diagnostic value of BI-RADS grade 4 palpation-negative breast lesions. Methods A retrospective analysis of 102 cases of clinical palpation negative, ultrasound BI-RADS grade 4 breast lesions of the ultrasound features and pathological findings, evaluation of breast ultrasound in the diagnosis of such patients. Results Among the 102 BI-RADS grade 4 lesions, 47 were benign tumors and 55 were malignant tumors with a positive predictive value of 53.9%. The positive predictive value of 4A was 15.6%, the positive predictive value of 4B was 56.1%, and the positive predictive value of 4C was 93.1%. The highest diagnostic sensitivity was 89.1%. The specificity of glitch, small lobe, microcalcification, posterior echo attenuation and grade Ⅱ ~ Ⅲ blood flow were higher, which were 95.7%, 87.2% 89.4%, 80.9%, 87.2%. Conclusion In the BI-RADS grade 4 lesions, the irregular shape has higher sensitivity to the diagnosis of breast cancer, and the glitches, small lobes, attenuation of the posterior echoes, microcalcifications, and grade II and III blood flow have a positive effect on breast cancer Diagnosis has a higher specificity.