| Objective:To explore the establishment of a standard model for quantitative scoring and classification of benign and malignant breast nodules by ultrasound imaging report and data system(US-BI-RADS),and to evaluate the application value of the model in the risk assessment of benign and malignant breast tumors.Methods:Collected 4,009 nodules from 3589 female breast tumor patients who came to Shanxi Cancer Hospital from January 2018 to January 2019(3623 from January to December 2018,386 from January 2019),preoperative ultrasound Examination,pathology after surgery or pathological results after puncture were regarded as the research objects.1.Using 3623 nodules from January to December 2018 as model cases,retrospectively analyze the ultrasound sonographic features of breast nodules to determine whether the nodules have irregular shapes,fuzzy edges or tiny lobes or angles or burrs There are 7 ultrasound malignant signs,uneven echo or mixed echo,echo attenuation behind the tumor,aspect ratio greater than 1,microcalcification in the lesion and dilation of adjacent ducts.2.Calculate the sensitivity,specificity,accuracy,PPV and NPV of the above 7 ultrasound signs to evaluate the benign and malignant breast nodules,and then analyze the weight of the relative risk(OR)value of the diagnosis of breast cancer,and give it according to the weight of each sign The corresponding assignment score.Combined with the age of the patient and given the corresponding assigned score,Age=0 points for those aged<35 years,1 point for those 35 years≤Age<50 years old,2 points for those aged≥50 years old,to establish benign and malignant breast nodules US-BI-RADS quantitative score classification standard model.3.Using ACR BI-RADS as the standard,propose the US-BI-RADS classification into 3categories,4 subcategories(category 4a,category 4b,category 4c)and category 5scoring standards,draw ROC curve and box plot,and then 386 nodules in January 2019were used as test cases to analyze the model to evaluate the diagnostic efficacy of benign and malignant breast nodules.Results:1.Sort according to the OR value of the above 7 malignant ultrasound signs:X4=rear echo attenuation(181.65)>X2=blurred edges or angled,etc.(37.55)>X3=uneven internal echo(22.86)>X5=nodule aspect ratio Greater than 1(18.68)>X1=irregular shape(13.70)>X7=adjacent duct dilatation(12.61)>X6=internal microcalcification(11.13),and assigned corresponding scores,the scores of benign and malignant breast nodules Total score=Age+X4*3+(X2+X3+X5)*2+(X1+X6+X7)*1.The area under the ROC curve is 0.985,and the 95% confidence interval is 0.981 to 0.989.Divide 5 into the demarcation nodes for the ultrasonic differential diagnosis of benign and malignant breast lesions.The sensitivity,specificity,accuracy,PPV,and NPV of benign and malignant breast tumors evaluated by ultrasound are 94.76%,99.18%,97.29%,98.85%,and 96.21%,respectively.2.According to the ACR BI-RADS standard,set Total score ≤ 2 into US-BI-RADS 3 types of nodules,3 into 4a nodules,4into 4b nodules,and 5 into 4c nodules,≥ 6 is divided into 5 types of nodules;the malignant composition ratios of model cases 3,4a,4b,4c,and 5 are 2.01%,5.26%,21.09%,91.75 after classification according to the quantitative scoring standard model.%,99.35%,and the malignant composition ratios of nodules in Type 3,Type 4a,Type 4b,Type 4c,and Type 5 test cases were 1.69%,6.06%,23.53%,90.91%,97.96%.Conclusion:The US-BI-RADS quantitative scoring and classification standard is more feasible,and the risk assessment of benign and malignant breast lesions is highly accurate,simple and easy to operate,and has important clinical application value. |
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