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超声内镜评分对消化道及壁外压迫性病变良恶性的诊断价值

, PP. 1382-1387

Keywords: 超声内镜,乳腺影像报告和数据系统,消化道,良恶性

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Abstract:

目的建立基于乳腺影像报告和数据系统(breastimagingreportinganddatasystem,BI-RADS)的EUS-BIRADS评分体系并评价其对消化道黏膜层、黏膜下及壁外压迫性病变良恶性的诊断价值。方法回顾性分析我院2006年6月至2012年12月经病理学诊断明确的消化道及壁外病变509例。参照BI-RADS超声诊断标准建立EUS-BIRADS评分体系,依据EUS-BIRADS评分体系在未知病理诊断情况下为每1组超声内镜图像评分,并将评分结果与病理结果比对。ROC曲线分析示AUG=0.947,取EUS评6.5分时为临界值(对应Youden指数最高值),分值>6分的病例倾向于恶性病变,分值≤6分者倾向于非恶性病变。利用Pearsonχ2检验、McNemarχ2检验、敏感度、特异度、阳性预测值、阴性预测值、Youden指数、诊断符合率、Kappa值等评估EUS-BIRADS评分体系的诊断价值。结果EUS-BIRADS评分对于黏膜层、黏膜下及壁外病变的良恶性评定的敏感度、特异度、阳性预测值、阴性预测值、Youden指数、诊断符合率、Kappa值分别为85.1%、92.9%、71.2%、96.8%、0.7795、91.6%、0.7234。Pearsonχ2检验(χ2值=269.573,P<0.001)示EUS-BIRADS评分结果与病理检验结果不独立,其列联系数R=0.728示两者正相关,但McNemarχ2检验(P值:0.014)示EUS-BIRADS评分体系与病理学诊断之间存在有差异。结论基于BI-RADS标准建立的EUS-BIRADS评分体系对消化道及壁外病变的良恶性的预判与病理诊断之间有较好一致性,可以辅助临床医师预判病变性质以利于进一步检查。

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