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目的探讨乳腺影像报告与数据系统(breast i maging reporting and data system,BI-RADS)对临床触诊阴性乳腺病灶(nonpalpable breast lesions,NPBL)进行活检的指导价值。方法对乳腺超声或X线摄影发现的触诊阴性乳腺病灶254个,按照BI-RADS对其分级,在影像定位下进行活检,获得组织学诊断。结果 254个触诊阴性病灶中,乳腺癌46个,阳性预测值(positive predictive value,PPV)为18.1%。按照BI-RADS分级,Ⅱ-Ⅴ级病灶癌的PPV分别为0.0%、5.8%、26.9%与73.3%,其中Ⅲ级病灶中乳腺癌病灶和良性病灶间年龄差异有统计学意义,未绝经与绝经阳性预测值分别为2.9%、14.8%,差别有统计学意义(P<0.05)。结论 BI-RADS分级提高了触诊阴性乳腺病灶影像诊断的特异性,可用于进行指导活检。
Objective To investigate the value of biopsy of nonpalpable breast lesions (clinically palpable breast lesions) by the Breast Imaging Reporting and Data System (BI-RADS). Methods A total of 254 palpation-negative breast lesions were detected by ultrasound or X-ray in the breast. The tumors were graded by BI-RADS, and biopsy was performed under the imaging orientation to obtain the histological diagnosis. Results Of the 254 palpation-negative lesions, 46 were breast cancer with a positive predictive value (PPV) of 18.1%. According to the BI-RADS classification, the PPV of grade Ⅱ-Ⅴ lesions were 0.0%, 5.8%, 26.9% and 73.3% respectively. There were significant differences in the age of breast lesions and benign lesions in grade Ⅲ lesions, The positive predictive value of menopause was 2.9% and 14.8%, respectively, with a significant difference (P <0.05). Conclusion The BI-RADS classification improves the specificity of imaging diagnosis of palpation-negative breast lesions and can be used for guiding biopsy.