摘要
目的 评价乳腺Ｘ线摄影诊断乳腺癌的准确性，探讨影响其敏感性和特异性的因素。方法 取经组织病理证实的４４３ 例良恶性乳腺病变的术前乳腺片（ 良性病变２５９ 例，恶性病变１８４ 例） ，根据乳腺Ｘ 线装置性能、投照位置、胶片、洗片机等技术特点不同将其分成两组：Ａ 组（ｎ ＝ １６３）和Ｂ组（ ｎ＝ ２８０）。①Ａ 组应用国产ＤＧＸ ＭＦ３０钼靶摄影装置，仅有两侧乳腺侧位片；②Ｂ组采用美国ＢＥＮＮＥＴＴ ＭＦ１５０ 乳腺摄影系统，有侧位和轴位片。然后由两位资深乳腺放射诊断医师分别采用盲法（ 不参考临床资料仅根据乳腺片的影像特点作出诊断） 和综合法（ 结合临床资料对乳腺片作出诊断） 对乳腺片进行分析辨别，最后将Ｘ 线分析结果与组织病理诊断作对照，根据有关真阳性、假阴性、真阴性及假阳性病例数，计算出相因的敏感性和特异性。结果 Ａ 组的乳腺Ｘ 线摄影的敏感性和特异性分别为：盲法７０３１％ 和７６７７ ％ ，综合法７８１３％ 和８３８３ ％ ；Ｂ组分别为：盲法８１６７ ％ 和８８７５ ％ ，综合法８９１７ ％ 和９３７５ ％ ，Ｂ组的乳腺Ｘ 线摄影的敏感性和特异性高于Ａ 组，而在相同的乳腺Ｘ线摄影技术条件下，综合法的敏感性和特异性高于盲法?
Purpose To determine the accuracy of mammography in diagnosing breast cancer and assessed what have an effect on sensitivity and specificity.Methods 443 breast diseases with histopathological verfication (259 benign,184 malignant),which were divided into two groups:①group A, 163 cases were underwent mammography with shanghai DGX MF 30 medical systems,standard lateral mammograms were available only;②group B,280 cases were underwent mammography with BENNETT MF 150 medical systems,the standard lateral and craninoocaudal mammograms were available.The mammograms were identified blind (do not relate to clinical data) and combined clinical data by two special radiologists who were blinded as to whether the benign or malignant lesion.At last,all the interpretations of radiologists were then compared with the histopathologically confirmed diagnosis.Results For sensitivity and specificity of mammography to breast cancer in group A:the blinded interpretation was 70% and 77%,the combined interpretation was 78% and 84%;in group B:the blinded interpretation was 82% and 89%,the combined interpretation was 89% and 94%,respectively.For sensitivity and specificity,the combined interpretation was higher than the blinded and group A was higher than group B.Conclusion Variability and limitations in accuracy remain.However,high quality mammograms and the combined interpretation can enhance the radiologists' ability to interpret mammograms with high sensitivity for detecting patients with cancer and high specificity for excluding patients without cancer.In order to mainatain the high quality mammograms,the strict technical standards and program for quality control is necessary. [
出处
《中国医学影像技术》
CSCD
北大核心
1999年第7期493-495,共3页
Chinese Journal of Medical Imaging Technology
关键词
乳腺癌
X线
敏感性
特异性
诊断
Breast cancer Mammography Sensitivity Specificity
