Abstract:

Objective　To investigate the value of automated breast ultrasound (ABUS) in the diagnosis of 4A benign and malignant breast nodules in the breast imaging reporting and data system (BI-RADS). Methods　Two hundred and two female patients with a total of 216 BI-RADS 4A breast nodules [the longest diameter was (17.92±11.60) mm] found by ABUS in Guangdong Provincial Hospital of Chinese Medicine from January 2018 to September 2022 were retrospectively analyzed; they were 23-72 years old. All the patients were examined by ABUS, conventional ultrasound, and mammography. The BI-RADS classification was conducted according to the classification standard of Breast Imaging Report and Data System established by the American College of Radiology (ACR) in 2013. The postoperative pathological results were used as the gold standard to analyze the diagnostic efficacies of the three methods. The χ² test or Fisher's exact probability method were used to compare the count data. Results　It was confirmed by surgery and pathology that 178 nodules were benign, and 38 malignant. The malignant composition ratios of B-RADS 4A breast nodules by ABUS, routine ultrasound, and mammography were 17.59% (38/216), 12.94% (22/170), and 19.61% (10/51), respectively. There were no statistical differences between the three groups in the malignant composition ratio of BI-RADS 4A nodules between by ABUS and by conventional ultrasound, between by ABUS and by mammography, and between by conventional ultrasound and by mammography (χ²=1.568, 0.114, and 1.408; all P>0.05). Conclusions　The diagnostic efficacy of ABUS for BI-RADS 4A breast nodules is similar to those of conventional ultrasound and mammography. ABUS has certain clinical value in early breast cancer screening, and is conducive to breast disease screening and disease grading management in grass-root units.

Key words:

Breast nodules, Automated breast ultrasound, Breast imaging reporting and data system, Diagnosis

摘要：

目的　探讨自动乳腺容积超声成像（ABUS）在乳腺影像报告和数据系统（BI-RADS） 4A类乳腺结节良、恶性诊断中的应用价值。方法　回顾性分析广东省中医院2018年1月至2022年９月经ABUS发现乳腺BI-RADS 4A类结节的202例女性患者，共216个乳腺结节［结节最大径（17.92±11.60）mm］，年龄23～72岁。患者均接受ABUS、常规超声、乳腺X线摄影，并根据美国放射学会（ACR）建立的2013年版BI-RADS进行分类，以术后病理结果作为金标准，分析3种检查方法的诊断效能。计数资料的比较采用χ²检验或Fisher确切概率法。结果　经手术病理证实，178个结节为良性，38个结节为恶性，ABUS、常规超声、乳腺X线摄影诊断BI-RADS 4A类结节的恶性构成比分别为17.59%（38/216）、12.94%（22/170）、19.61%（10/51），3种检查诊断BI-RADS 4A类结节的恶性构成比进行组间比较（ABUS与常规超声、ABUS与X线、常规超声与X线），差异均无统计学意义（χ²=1.568、0.114、1.408，均P>0.05）。结论　ABUS对BI-RADS 4A类乳腺结节的诊断效能与常规超声、乳腺X线摄影相仿，ABUS在早期乳腺癌筛查中有一定临床价值，有利于基层单位乳腺疾病筛查及疾病分级管理。

关键词:

乳腺结节病, 自动乳腺容积超声成像, 乳腺影像报告和数据系统, 诊断