对乳腺BI-RADS Ⅲ级病变X线钼靶影像学动态观察分析
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摘 要：目的 探讨对乳腺影像报告与数据系统 BI-RADS Ⅲ级病变的动态诊断价值。方法 本组病例203 例初诊为乳腺BI-RADS Ⅲ级病变，并均经临床随诊追查三年以上，病理证实乳腺良、恶性肿块病变；患者均为女性，年龄 28-60岁，所有病例均行临床查体、X线钼靶和超声检查，并均经手术病理证实，回顾性分析X线钼靶和超声表现，总结X线钼靶在影像学诊断中的特点。结果 X 射线钼靶图像表现以片状致密影、结节状影、钙化影、结构紊乱，周围纤维间隔纠集多见；结合超声检查对乳腺肿块诊断灵敏度为91.69 %，误诊率为9.36 %，符合率为90.64%，明显高于两者单独应用，差异有显著统计学意义P<0.01。结论 X 射线钼靶影像学表现有其长处和不足，存在诊断难点，与超声联合应用能提高乳腺肿块 BI-RADS Ⅲ级检出率及良、恶性鉴别诊断的准确性，并需建立追查制度。 关键词：乳腺BI-RADS分级 X 线钼靶 病理 影像分析Abstract： Objective To investigate the application value of breast imaging reporting and data system(BI-RADS) III lesions by X-ray mammography. Methods A total of 203 patients with BI -RADS III lesions confirmed by pathological diagnosis were enrolled, female and dynamic observation of three years, aged 28 - 60 years old. All of them underwent clinical examination, mammography and trusting of pathology after operated, analysis signs and summarized radiographic features of mammography. Results The performance of X-ray mammography images often showed shades of flake dense，nodules, calcification, structure disorderly . The sensitivity of combination diagnosis for breast lumps was 91.69 %, the misdiagnosis rate was 9.36 % and conform rate was 90.64%, which were obviously higher than single application, the difference was statistically significant (P < 0.01). Conclusion It is demonstrated that the mechanism of mammography and ultrasound imaging are different.Combination of the two approaches could improve the BI - RADS III detection rate and accuracy of differential diagnosis between benign and malignant lesion and need establishing investigate system ......
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