| ObjectiveTo study and compare the value of applying BI-RADS(Breast Imaging Reporting And Data System)classification in ultrasound and molybdenum target X –ray mammography for the differential diagnosis of breast mass by comparing and analyzing the relationship between the BI-RADS classification of color Doppler ultrasound And X-ray mammography and pathological diagnosis.Method238 patients,including 269 breast lesions who came to Chaoyang Central Hospital in Liaoning Province because of “breast mass†from July 2012 to October 2014 were selected as the study subjects. All the objects who received color Doppler ultrasound and X-ray mammography before operation were diagnosed by biopsy or postoperative pathology. Respectively from the overall,young(age<40)women,older(age 40 or higher),three aspects are studied. Analyzing the ratio of malignant tumor in each level of the BI-RADS classification of color Doppler ultrasound and X-ray mammography on the results of pathological diagnosis. Through the contrast of color doppler ultrasonography and mammography at all levels of diagnosis index(sensitivity and specificity), to select the critical value(level below the critical value is negative, the critical value and above level is positive). And through ROC curve drawing, calculate the area under the ROC curve(AUC) of color Doppler ultrasonography and X-ray mammography for differential diagnosis of benign and malignant breast mass, to choose the diagnostic value of the best way to check. All patients aged 16 to 78 years old, mean(47.1±12.2) years old. 53 patients including 64 breast lesions under 40 years old(40 years old was not included)and 185 patients including 205 breast lesions over 40 years old(40years old was included)were included.ResultFor overall,BI-RADS level 1 ultrasonic is absent, the ratio of malignant tumour of the X-ray is 0%; BI-RADS 2 class, the ratio of ultrasonic malignant tumor is 0%, the ratio of A-ray is 2.9%; BI-RADS level 3, the ratio of ultrasonic malignant tumor is 2.0%, the ratio of X-ray is 13.6%; BI- RADS 4A, the ratio of ultrasonic malignant tumor is 24.6%, the ratio of X-ray is 35%; BI- RADS 4B, the ratio of ultrasonic malignant tumor is 85.2%, the ratio of X-ray is 72.7%; BI- RADS 4C level, the ratio of ultrasonic malignant tumor is 97.9%, the ratio of X-ray is 87.0%; BI- RADS level 5, the ratio of ultrasonic malignant tumor is 100%, the ratio of X-ray is 97.2%.With grade 4B of BI-RADS classification as the positive critical point(level 1,level 2,level 3,level 4A as the negative results;level 4B,level 4C,level 5 as positive results)the sum of sensitivity and specificity of ultrasound and mammography is maximum,1.807 and 1.783,respectively,and the area(AUC)under the receiver operator characteristic curve( ROC) were 0.951 and 0.942,respectively;For the young women who aged beyond 40(40 years old was not included),BI- RADS level 1 ultrasonic is absent, the ratio of malignant tumour of the molybdenum target is 0%; BI- RADS level 2, the ratio of ultrasonic malignant tumor is 0%, the ratio of molybdenum target is 0%; BI-RADS level 3, the ratio of ultrasonic malignant tumor is 0%, the ratio of molybdenum target is 0%; BI- RADS 4A, the ratio of ultrasonic malignant tumor is 12.5%, the ratio of molybdenum target is 20%; BI- RADS 4B, the ratio of ultrasonic malignant tumor is 66.7%, the ratio of molybdenum target is 100%; BI- RADS 4C level, the ratio of ultrasonic malignant tumor is 100%, the ratio of molybdenum target is 100%; BI- RADS level 5, the ratio of ultrasonic malignant tumor is 100%, the ratio of molybdenum target is 100%.With grade 4B of BI-RADS classification as the positive critical point,the sum of sensitivity and specificity of ultrasound was maximum,mean 1.76,and with grade 4A of BI-RADS classification as the positive critical point,the sum of sensitivity and specificity was maximum,mean 1.926,the AUC of ultrasound and mammography were 0.959 and 0.996,respectively;For the women who aged over 40(40 years old was included),BI- RADS level 1 ultrasonic is absent, the ratio of malignant tumor of the molybdenum target is 0%; BI-RADS 2 level, ultrasound is absent, the ratio of molybdenum target malignant tumor is 4.9%; BI- RADS level 3, the ratio of ultrasonic malignant tumor is 3.3%, the ratio of molybdenum target is 20%; BI – RADS 4A, the ratio of ultrasonic malignant tumor Is 29.3%, the ratio of molybdenum target is 40%; BI- RADS 4B, the ratio of ultrasonic malignant tumor was 87.5%, the ratio of molybdenum target is 70.6%; BI- RADS 4C level, the ratio of ultrasonic malignant tumor is 97.8%, the ratio of molybdenum target is 84.2%; BI- RADS level 5, the ratio of ultrasonic malignant tumor is 100%, the ratio of molybdenum target malignant tumor is 97%.With grade 4B of BI-RADS classification as the positive critical point, the sum of sensitivity and specificity of ultrasound and mammography is maximum,1.799 and 1.74, respectively,and the AUC were 0.945 and 0.925,respectively.Conclusions:1 The ratio of malignant tumor in each BI- RADS classification in this study is not the same with the results the ACR released.2 For overall,by using BI-RADS classification,the value of application of color Doppler ultrasound in the diagnosis of breast neoplasm is greater than the value of X-ray mammography in the diagnosis of breast neoplasm.3 For the young women who aged beyond 40(40 years old was not included),by using BI-RADS classification,the value of application of color Doppler ultrasound in the diagnosis of breast neoplasm is less than the value of X-ray mammography in the diagnosis of breast neoplasm.4 For the women who aged over 40(40 years old was included),by using BI-RADS classification,the value of application of color Doppler ultrasound in the diagnosis of breast neoplasm is greater than the value of X-ray mammography in the diagnosis of breast neoplasm.5 By using BI-RADS classification,the application value of color Doppler ultrasound In the identification of benign and malignancy of breast neoplasm is greater than the value of X-ray mammography. |
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