| 王涌,秦茜淼,杨宝年,陈莉,王怡.探讨超声BI-RADS分类误诊乳腺原位癌的原因[J].中国医学影像技术,2012,28(11):2019~2022 |
| 探讨超声BI-RADS分类误诊乳腺原位癌的原因 |
| Causes of US BI-RADS misdiagnosis of breast ductal carcinoma in situ |
| 投稿时间：2012-04-21 修订日期：2012-09-10 |
| DOI： |
| 中文关键词: 超声检查 乳腺肿瘤 癌,原位 |
| 英文关键词:Ultrasonography Breast neoplasms Carcinoma in situ |
| 基金项目:上海市重点学科建设项目(B112)。 |
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| 中文摘要: |
| 目的 探讨超声BI-RADS分类误诊乳腺导管内原位癌(DCIS)的原因。方法 回顾性分析经病理证实的487例乳腺导管上皮内瘤变(DIN)(包括447例DCIS及40例良性DIN)的超声表现及超声BI-RADS分类诊断结果。结果 超声BI-RADS分类诊断DCIS的准确率、敏感度和特异度分别为75.15%(366/487)、76.73%(343/447)和57.50%(23/40);诊断Ⅱ型DIN的准确率明显低于Ⅲ型和Ⅳ型(χ2=27.189,P<0.001)。伴发钙化灶见于54.36%(243/447)的DCIS,明显高于良性DIN(5/40,12.50%),差异有统计学意义(χ2=25.747,P<0.001)。超声BI-RADS分类对于不伴发超声可见钙化的DCIS的误诊率为33.82%(69/204),明显高于伴发钙化者(35/243,14.40%),差异有统计学意义(χ2=23.428,P<0.001)。结论 病灶长径＜10 mm或声像图中未见实质性肿物及钙化是超声BI-RADS分类漏诊和误诊DCIS的主要原因。 |
| 英文摘要: |
| Objective To explore the causes of US BI-RADS misdiagnosis of breast ductal carcinoma in situ (DCIS). Methods Totally 487 patients with ductal intraepithelial neoplasia (DIN) proved by pathologies were reviewed, including 447 DCIS and 40 benign DIN. The ultrasonic manifestation and US BI-RADS category were analyzed. Results The accuracy, sensitivity and specificity of US BI-RADS to identify DCIS was 75.15% (366/487), 76.73% (343/447) and 57.5% (23/40), respectively. The diagnostic accuracy of type Ⅱ was significantly lower than that of type Ⅲ and Ⅳ (χ2=27.189, P<0.001). Calcifications were observed in 54.36%(243/447) DCIS, significantly higher than benign DIN (5/40, 12.50%, χ2=25.747, P<0.001). The misdiagnosis rate of DCIS without detectable calcifications was 33.82% (69/204), significantly higher than that of DCIS with calcifications (35/243, 14.40%, χ2=23.428, P<0.001). Conclusion The main causes of DCIS missed and misdiagnosed with US BI-RADS include length smaller than 10 mm, without solid masses nor ultrasonic detectable calcifications. |
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