【作者】 袁一杰；

【导师】 张苏展；

【作者基本信息】 浙江大学 ， 肿瘤外科， 2012， 硕士

【摘要】 目的：本文旨在建立一个以BI-RADS-US分级为基础并结合本院实际的乳腺超声影像评分系统,探讨该系统在乳腺肿块良恶性鉴别诊断中的应用价值。方法：统计2012年1月至2012年2月,浙江大学医学院附属第二医院肿瘤外科收治的乳腺肿块病例共80例,参照BI-RADS-US标准建立乳腺超声影像评分系统,对其术前超声影像进行评分,并与术后病理诊断金标准(gold standard)进行比照。计数良性组评分与恶性组评分,验证二者是否存在显著性差异,并根据约登指数(Youden’s index)选择合适的数值作为超声诊断乳腺肿块良恶性的阈值。结果：经手术病理证实为恶性肿瘤42例、良性肿瘤38例,其中恶性肿瘤组评分在6-10分,平均为8.6±1.083,中位数为9分；良性肿块组评分在5-8分,平均分为5.71±0.956,中位数为5分。两组间有显著性差异(P<0.05)。为达到最大真实性选择8分作为诊断乳腺恶性肿块的下限,6分作为诊断乳腺良性肿块的上限；该评分系统对乳腺恶性肿块诊断的阳性预测值为：94.6%,阴性预测值为：83.7%；对乳腺良性肿块诊断的阳性预测值为：93.5%,阴性预测值为81.6%。结论：该评分系统在乳腺良恶性病变鉴别诊断方面有较高的敏感性和特异性,对临床医生鉴别乳腺肿块的良恶性程度有重要参考意义。更多还原

【Abstract】 Objective:This article aims to explore the use of breast ultrasound imaging scoring system in differential diagnosis of benign and malignant breast lumps.Methods:From Jan.2012to Feb.2012, retrospective study of the ultrasound images and pathology diagnosis of80patients with breast lumps, establish a breast ultrasound imaging scoring system based on BI-RADS-US(Breast imaging reporting and data system-Ultrasound), calculate the malignant group and benign group’s score, and set a threshold to diagnose the benign breast and malignant breast lumps. Sensitivity, specificity, positive predictive rate, negative predictive rate of ultrasonography were measured.Results:Confirmed by pathology,42cases of malignant tumors,38cases of benign tumors; The score of malignant group is6-10, average of8.6±1.083, median of9; The score of benign tumor group is5-8, average of5.71±0.956, median of5points. Between the two groups, there are significant differences (P<0.05). Select points8as lower limit of the diagnosis of malignant breast lumps, select points6as upper limit of the diagnosis of benign breast lumps; To the malignant breast lumps, the positive predictive value is94.6%, negative predictive value is83.7%; To the benign breast lumps, the positive predictive value is93.5%, negative predictive value is81.6%. Conclusion:Scoring system of breast ultrasound imaging has high sensitivity and specificity in the differential diagnosis of benign and malignant breast lesions.更多还原