Objective To investigate the clinical value of breast imaging reporting and data system ( BI-RADS) for diagnosing benign and malignant breast masses. Methods From August 2010 to August 2014 80 cases (96 tumors) taking breast color Doppler ultrasonography were recruited from Shangyu Chinese Medicine Hospital, and all of the tumors were diagnosed with BI-RADS and compared with pathological results. The accuracy of BI-RADS grading diagnosis was evaluated and the differences in ultrasonic features between benign and malignant tumors were explored. Results BI-RADS grading diagnosis for grade <4 and >4 was coincident with pathological findings, and the specificity and accuracy were 100. 00%. In diagnosing tumors of grade 4, positive predictive value was low (50. 00%), but the specificity and accuracy were relatively high (86. 21%, 87. 88%). The major ultrasonic features of benign tumors were clear boundary (91. 25%), regular shape (90. 00%), internal high-echo (95. 00%), insufficient blood supply (93. 75%), organizational integrity (96. 25%), normal axillary lymph node (98. 75%) and positive CDFI (26. 25%), and the detection rates of them were significantly different from those of malignant tumors (χ2 value was 28. 474, 33. 241, 42. 456, 21. 374, 15. 227, 34. 084 and 54. 264, respectively, all P<0. 05). Conclusion Ultrasound BI-RADS grading diagnosis is an accurate way to diagnose benign and malignant breast tumor except for grade 4 tumors. Ultrasonic features of benign and malignant tumors are different, and there is clear boundary and shape in benign tumors with no internal echo.%目的：探讨在乳腺肿块良恶性诊断中应用超声乳腺影像报告和数据系统( BI-RADS)分级指导诊断的临床价值。方法选择2010年8月至2014年8月在绍兴市上虞中医医院就诊的80例实施乳腺多普勒彩色超声诊断患者,共96例次肿块,对所有肿块应用超声BI-RADS分级系统诊断确定其良恶性,并与手术病理结果对比,评价超声BI-RADS分级诊断的准确性,对比良性肿块与恶性肿块超声表现的差异。结果 BI-RADS 分级诊断<4级、>4级与病理结果一致,特异性和准确度均为100.00%,诊断4级阳性预测值较低(50.00%),特异性及准确度较好,达86.21%、87.88%。良性肿块超声表现主要为边界清晰(91.25%)、形态规则(90.00%)、内部中高回声(95.00%)、血供不丰富(93.75%)、组织完整(96.25%)、腋下淋巴结正常(98.75%)、彩色多普勒表现(CDFI)阳性(26.25%),以上检出率与恶性肿块对比差异均有统计学意义(χ2值分别为28.474、33.241、42.456、21.374、15.227、34.084、54.264,均P<0.05)。结论超声BI-RADS分级诊断乳腺良恶性肿块较准确,但对4级肿块准确率不高,需结合其他手段评价肿块性质,良恶性肿块超声表现差异大,良性肿块边界及形态清楚,内部无低回声。
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