摘要
目的探讨数字乳腺三维断层摄影技术(DBT)在乳腺可疑钙化型疾病诊断中的应用。方法选择2016年3月至2018年3月在郑州大学附属肿瘤医院就诊的乳腺可疑钙化型病变患者135例,分别使用DBT及FFDN(全数字化乳腺摄影)进行独立诊断,评价两者对乳腺可疑钙化型病变的诊断结果。结果135例患者中,恶性病变43例,良性病变92例。DBT与FFDM对乳腺可疑钙化诊断的灵敏度分别为93.0%(40/43)和88.4%(38/43),特异度分别为88.0%(81/92)和75.0%(69/92),准确性分别为89.6%(121/135)和79.3%(107/135),DBT的良性正确诊断率及总体正确诊断率均优于FFDM,差异有统计学意义(P<0.05);两组在恶性正确诊断率方面无明显差异。两组的ROC曲线下面积(AUC)为0.905±0.026及0.817±0.034,差异具有统计学意义(P=0.0002)。在绝经前患者中,DBT组及FFDM组诊断乳腺可疑钙化的ROC曲线下面积(AUC)分别为0.898±0.0345及0.833±0.0396,差异具有统计学意义(P=0.005)。在绝经后患者中,两组的ROC曲线下面积(AUC)分别为0.916±0.0402及0.788±0.0613,差异有统计学意义(P=0.0118)。在乳腺密度ACR3-4病例中,两组的ROC曲线下面积(AUC)分别为0.908±0.0300及0.817±0.0384,差异有统计学意义(P=0.0009)。在乳腺密度ACR1-2病例中,两组对乳腺可疑钙化的诊断准确度差异无统计学意义(P=0.1026)。DBT与FFDM对良性钙化的BI-RADS分类差异有统计学意义(x^2=11.740,P=0.0385),对恶性钙化的BI-RADS分类差异无统计学意义。结论DBT对乳腺可疑钙化病变诊断价值较高,对于良性钙化的鉴别诊断有明显优势。
Objective To explore the diagnostic value of digital breast tomosynthesis technique (DBT)in breast suspicious calcified lesions.Methods Clinical data of 135 patients using DBT and FFDM (Full field digital mammography)was respectively analyzed.Results Of the 135 cases,43 cases were malignant,and 92 cases were benign.The diagnostic sensitivity DBT and FFDM were 93.0%(40/43) and 88.4%(38/43),specificity were 88.0%(81/92)and 75.0%(69/92),accuracy were 89.6%(121/ 135)and 79.3%(107/135),the differences were statistically significant (P <0.05).The ROC curve area (AUC)of DBT and FFDM were 0.905±0.026and 0.817±0.034(P =0.0002).In premenopausal, postmenopausal and breast density ACR3-4cases,DBT accuracy is higher than FFDM (P <0.05).The BIRADS classification difference of the benign calcified lesions was statistically significant (x^2=11.740,P = 0.0385).Conclusions Compared with the traditional FFDM,DBT has a higher value in the diagnosis of breast suspicious calcified lesions,especially for benign calcified lesions.
作者
李军涛
郭旭辉
田沛琦
付晓谧
李连方
崔树德
张恒伟
Li Juntao;Guo Xuhui;Tian Peiqi;Fu Xiaomi;Li Lianfang;Cui Shude;Zhang Hengwei(Breast Diseases Center,Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2018年第12期1042-1045,共4页
Chinese Journal of General Surgery
基金
河南省医学科技攻关计划普通项目(201702250).
关键词
乳腺疾病
乳房X线摄影术
数字乳腺三维断层摄影
乳腺可疑钙化
Breast diseases
Mammography
Digital breast tomosynthesis technique
Breast suspicious calcified lesions
