| 买牧春，宗燕君.超声引导穿刺活检与MRI在诊断BI-RADS 4类乳腺肿块中的价值研究[J].实用中西医结合临床,2023,23(10):80-84 |
| 超声引导穿刺活检与MRI在诊断BI-RADS 4类乳腺肿块中的价值研究 |
| Ultrasound-Guided Needle Biopsy with MRI in the Diagnosis of BI-RADS Class 4 Value Studies in Breast Masses |
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| DOI： |
| 中文关键词: 乳腺肿块 BI-RADS 4 超声引导穿刺活检 MRI |
| 英文关键词: Breast mass BI-RADS 4 Ultrasound-guided needle biopsy MRI |
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| 中文摘要: |
| 目的：探讨超声引导穿刺活检与核磁共振成像（Magnetic Resonance Imaging, MRI）在诊断乳腺影像报告和数据系统4类乳腺肿块（Breast Imaging Report And Data System 4, BI-RADS 4）中的诊断效能，为BI-RADS 4类乳腺肿块的诊疗提供临床依据。方法：选取2021年2月至2023年2月安阳市肿瘤医院收治的90例疑似BI-RADS 4类乳腺肿块患者作为研究对象，以超声引导穿刺活检组织最终石蜡病理诊断为金标准，明确肿块病理结果，对比MRI检查结果在BI-RADS 4类乳腺肿块中其亚型病理和诊断效能。结果：所有乳腺肿块经石蜡病理证实，34例良性肿瘤中67.65%为纤维腺瘤，56例恶性肿瘤中80.36%为浸润性导管癌；在MRI检查中，BI-RADS 4a类乳腺肿块病灶中83.33%为良性肿块；BI-RADS 4c类乳腺肿块病灶中92.00%为恶性肿块；超声引导穿刺活检阳性检出共55例，阳性检出率为61.11%；MRI检查阳性检出共53例，阳性检出率为58.89%，两种检查方式阳性检出率比较，差异无统计学意义（P＞0.05）；经MRI检查后，其准确度、敏感度、特异度、阴性预测值、阳性预测值与超声引导穿刺活检诊断结果比较，差异无统计学意义（P＞0.05）。结论：在疑似BI-RADS 4类乳腺肿块中，BI-RADS 4a、BI-RADS 4c肿块病灶性质分别以纤维腺瘤、浸润性导管癌为主，且MRI检查结果与超声引导穿刺活检均具有较高的诊断效能。因此对于MRI检查BI-RADS 4a肿块患者可选择定期复查并观察肿块变化，而对BI-RADS 4c肿块患者强烈建议尽早穿刺活检以明确肿块病理性质。 |
| 英文摘要: |
| Objective: To explore the diagnostic efficacy of ultrasound-guided needle biopsy and Magnetic Resonance Imaging(MRI) in the diagnosis of Breast Imaging Report And Data System 4(BI-RADS 4) to provide a clinical basis for the diagnosis and treatment of BI-RADS 4 breast masses. Methods: A total of 90 patients admitted to Anyang cancer hospital from February 2021 to February 2023 were selected as the study subjects. The final paraffin pathological diagnosis of ultrasound-guided needle biopsy tissue was taken as the gold standard, the pathological results of the mass were defined. Contrast MRI findings for their subtype pathology and diagnostic efficacy in BI-RADS 4 breast masses. Results: All breast masses were confirmed by paraffin pathology, and 67.65% of 34 benign tumors had fibroadenomas and 80.36% of 56 malignant tumors had invasive ductal carcinoma. In the MRI examination, 83.33% of BI-RADS 4a breast masses were benign, and 92.00% of BI-RADS 4c breast masses were malignant.A total of 55 cases were detected by ultrasound guided needle biopsy, and the positive detection rate was 61.11%, a total of 53 cases were detected in MRI, and the positive detection rate was 58.89%. There was no statistical significance in the difference between the two positive detection methods（P＞0.05）. After MRI examination, the accuracy, sensitivity, specificity, negative predictive value, positive predictive value and the diagnostic results of ultrasound-guided needle biopsy were not significantly different（P＞0.05）.Conclusions: In the suspected BI-RADS 4 breast masses, the focal properties of BI-RADS 4a and BI-RADS 4c masses were mainly fibroadenoma and invasive ductal carcinoma, respectively, and MRI results and ultrasound guided needle biopsy have high diagnostic efficacy. Therefore, for patients with MRI for BI-RADS 4a mass, regularly review and observe the changes of the mass, while early puncture biopsy is strongly recommended to clarify the pathological nature of the mass. |
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