左艳玲?何广敏?李涛?刘观成?罗春月

    【摘要】 目的 探讨高频超声彩色像素密度(CPD)在乳腺影像报告和数据系统(BI-RADS)4类乳腺肿块良恶性鉴别诊断中的价值。方法 收集经术后病理确诊的81个BI-RADS 4类乳腺肿块的相关资料。所有肿块均于术前行彩色模式超微血管成像(cSMI)检查，利用超声诊断仪自带软件计算CPD，以病理活组织检查结果为金标准，通过受试者操作特征曲线下面积(ROC AUC)评估CPD的诊断效能，利用CPD对BI-RADS分类进行校正，对比校正前后BI-RADS分類对乳腺肿块良恶性鉴别诊断的灵敏度、特异度、准确度、阳性预测值、阴性预测值。结果 CPD对乳腺肿块良恶性鉴别的ROC AUC为0.854(P < 0.05)，获得CPD的截断值9.55%，该CPD值对乳腺肿块良恶性鉴别诊断的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为73%、83%、78%、85%和71%;经CPD校正BI-RADS分类后的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为87%、83%、85%、87%和83%，略高于校正前的80%、67%、74%、75%和73%。正确分类的比例提高了23%(P < 0.05)。结论 高频超声中CPD对鉴别乳腺肿块良恶性有一定价值，临床实践时可使用CPD校正BI-RADS分类，以提高其对4类乳腺肿块良恶性的鉴别诊断效能。

    【关键词】 高频超声;彩色像素密度;乳腺肿块;鉴别诊断;乳腺影像报告和数据系统

    The value of high-frequency ultrasonic color pixel density in differential diagnosis of BI-RADS 4 breast masses Zuo Yanling， He Guangmin， Li Tao， Liu Guancheng， Luo Chunyue. Department of Ultrasonic Function， Affiliated Cancer Hospital & institute of Guangzhou Medical University， Guangzhou 510095， China

    Corresponding author， He Guangmin， E-mail： 764604608@qq.com

    【Abstract】 Objective To explore the value of color pixel density (CPD) in differential diagnosis of Breast Imaging Reporting and Data System (BI-RADS) 4 breast masses by high-frequency ultrasound. Methods Relevant data of 81 pathologically-confirmed BI-RADS 4 breast masses were collected. All the masses were examined with color Super Microvascular Imaging (cSMI) before operation. CPD was calculated with the integrated software in the ultrasonic diagnostic instrument. Pathological biopsy results were regarded as the gold standard. The area under the receiver operating characteristic curve (ROC AUC) was created to evaluate the diagnostic efficiency of CPD. BI-RADS categories were corrected by CPD ......