分析超声BI-RADS分级在结合弹性成像并调整分级后对乳腺肿块的诊断价值。

回顾性分析2016年1月至12月南方医科大学附属东莞人民医院进行手术或活检获得病理结果的乳腺肿块，比较术前常规超声BI-RADS分级（US-BI-RADS）和结合弹性成像并调整后的BI-RADS分级（UE-BI-RADS）诊断乳腺肿块的价值。

US-BI-RADS对3~5级病灶诊断恶性的阳性预测值分别为0.86%、6.80%、26.04%、71.58%、91.25%；UE-BI-RADS分别为0.57%、6.67%、31.91%、79.31%、96.77%。US-BI-RADS诊断乳腺恶性肿瘤的敏感度为82.22%，特异度为88.43%，约登指数为0.71，ROC曲线下面积为0.919；UE-BI-RADS诊断的敏感度为87.18%，特异度为88.98%，约登指数为0.76，ROC曲线下面积为0.941。

UE-BI-RADS能提高超声对乳腺恶性病变的诊断价值；对US-BI-RADS 4级以上的病灶，有必要进行弹性成像后调整评分。

To evaluate the value of modified ultrasound BI-RADS classification by elastography in the diagnosis of breast masses.

According to the pathological results of surgery or biopsy of breast masses between January to December 2016 in Dongguan People’s Hospital Affiliated to Southern Medical University, the results of ultrasound breast imaging reporting and data system (US-BI-RADS) and modified US-BI-RADS by elastography (UE-BI-RADS) were analyzed respectively, then to compare the value of two methods in the diagnosis of breast masses.

The positive predictive value (PPV) of US-BI-RADS in diagnosing malignant lesions of grade 3-5 lesions was 0.86%, 6.80%, 26.04%, 71.58%, 91.25%, respectively; and of UE-BI-RADS was 0.57%, 6.67%, 31.91%, 79.31%, 96.77%, respectively. The sensitivity, specificity, Youden index and area under curve of US-BI-RADS were 82.22%, 88.43%, 0.71 and 0.919, and those of US-BI-RADS were 87.18%, 88.98%, 0.76, 0.941.

UE-BI-RADS can improve the diagnostic value of ultrasound for breast malignant lesions. For lesions above Grade 4, it is necessary to adjust the BI-RADS after elastography.