BIRADSforX的变化分析讲义.ppt

BIRADSforX的变化分析;2014年1月美国放射学院(ACR)公布了2013年新版乳腺影像报告和数据系统(Breast Imaging Reporting and Data system ，BI-RADS) 其中，适用于乳腺摄影(Mammography)是第5版，适用于超声和MRI均是第2版 ;BI-RADS的作用;2013年版BI-RADS的更新;乳腺X线摄影BI-RADS部分更新细节;Category 0：Incomplete—Need Additional Imaging Evaluation and/or Prior Mammograms for Comparison.;Category 1：Negative.;Category 2：Benign Finding(s).;Category 3：Probably Benign Finding—Initial Short–Interval Follow–Up Suggested. (less than a 2% risk of malignancy).;Category 4：Suspicious Abnormality—Biopsy Should Be Considered. ;Category 4A may be used for a finding needing intervention but with a low suspicion for malignancy.;Category 4B includes lesions with an intermediate suspicion of malignancy.;Category 4C includes findings of moderate concern, but not classic for malignancy.;Category 5：Highly Suggestive of Malignancy—Appropriate Action Should Be Taken (Almost certainly maligant). (high probability (≥95%) of being cancer).;Category 6：Known Biopsy–Proven Malignancy—Appropriate Action Should Be Taken.;BI-RADS分类适用于乳腺X线摄影(2013年版);乳腺X线摄影BI-RADS部分更新细节;乳腺实质构成分类Breast Composition Categories;a类 双乳几乎都为脂肪(breasts are almost entirely fatty);b类 纤维腺体密度小区域性分散存在(scattered areas of fibroglandular density);c类 双乳不均匀性致密，可遮掩小肿块(breasts are heterogeneously dense, which may obscure small masses); 本例右乳外上象限局部纤维腺体组织较致密，可以遮掩小肿块，所以乳腺实质结构分类应为c类，即双乳不均匀性致密(HETEROGENEOUSLY DENSE)，既使，所含的纤维腺体致密组织(fibroglandular-density tissue)的体积远小于整个乳腺体积的50%;d类 双乳极度致密，使乳腺摄影敏感性降低(breasts are extremely dense, which lowers the sensitivity of mammography);乳腺X线摄影BI-RADS部分更新细节;重要征象;1003890双乳良性结节，左乳囊肿，右乳腺瘤;999024右乳良性结节，纤维腺瘤;1031118双乳良性结节，纤维腺瘤;1094323右乳结节，边缘模糊，弥漫大B淋巴瘤;1019635右乳钙化、结节影，局部皮肤凹陷，浸润性导管癌Ⅱ级;1009599A右乳恶性、血管增粗，浸润性导管癌Ⅰ级;1026680A 67 发现左乳肿物2天，浸润性导管癌Ⅱ级;重要征象;典型良性钙化;右乳良性钙化;924079A左乳良性结节，良性钙化;1119167右乳良性钙化;无定型钙化：60%为良性，20%为恶性 BI-RADS 2：弥漫或双侧分布 BI-RADS 3：多发、双侧、簇状分布 BI-RADS 4：单侧簇状分布 或随访中新出现的钙化 或患者对侧有乳腺癌病史;F/53，左乳增生，导管扩张伴导管内钙盐沉积;F/38，左乳无定型及多形态钙化，乳腺囊性增生;DCIS伴局部浸润性导管癌