摘要
目的探讨数字乳腺断层合成摄影(DBT)对乳腺影像表现为不典型纤维腺瘤的诊断价值。资料与方法回顾性分析经手术病理证实为乳腺纤维腺瘤,以数字乳腺摄影(DM)及超声检查(US)图像为基准,影像表现不典型为形态不规则、边界不清、边缘成角或毛刺状、高密度、纵横比>1、后方回声衰减、伴有可疑恶性钙化、局灶性不对称致密、结构扭曲以及单一检查结果为假阴性的545例患者共688个病灶;术前均进行乳腺DBT、DM和US检查。参照第5版乳腺影像报告与数据系统(BIRADS)对肿块型病变进行评估,进行BI-RADS分类和乳腺致密度分类。比较DBT、DM及US对乳腺影像表现为不典型纤维腺瘤的检出率和诊断准确率的差异。结果 DBT、DM及US对乳腺影像表现为不典型纤维腺瘤的检出率分别为69.5%(478/688)、43.8%(301/688)、99.4%(684/688),3种检查方法两两检出率比较,差异均有统计学意义(均P<0.05)。DBT、DM及US对乳腺影像表现为不典型纤维腺瘤的诊断准确率分别为60.8%(418/688)、23.3%(160/688)、91.1%(627/688),DBT及US的诊断准确率均高于DM,3种检查方法两两诊断准确率比较,差异均有统计学意义(均P<0.01)。结论 DBT对乳腺影像表现为不典型纤维腺瘤的检出及诊断准确性具有明显优势,较DM更能清楚地显示病灶边缘,使BI-RADS分类更趋向于良性;但检出及诊断准确性较US低。
Purpose To discuss digital breast tomosynthesis (DBT) in the diagnosis of breast fibroadenoma with atypical imaging. Materials and Methods A retrospective analysis was performed on total 688 lesions in 545 patients who were confirmed by operation and pathology as breast fibroadenoma, whose digital mammography (DM) and ultrasonography (US) images showed the following atypical imaging: irregular shape, obscure boundary, angular or burr-shaped edge, high density, aspect ratio>1, rear echo attenuation, suspicious malignant calcification, focal asymmetric density, structure distortion and false negative under single examination method, and all 688 lesions are subject to breast DBT, DM and US examination before operation. Then, the mass lesions were assessed with reference to the 5th edition of breast imaging report and data system (BI-RADS) to perform the BI-RADS classification and breast density classification. Next, the difference in the detection rate and diagnostic accuracy of DBT, DM and US on breast fibroadenoma with atypical imaging was compared. Results The detection rate of DBT, DM and US on breast fibroadenoma with atypical imaging was 69.5%(478/688), 43.8%(301/688) and 99.4%(684/688), respectively;and the difference in detection rate between DBT and DM, DBT and US, DM and US was statistically significant (all P<0.05). Moreover, the diagnostic accuracy of DBT, DM and US on breast fibroadenoma with atypical imaging was 60.8%(418/688), 23.3%(160/688), and 91.1%(627/688), respectively;the diagnostic accuracy of both DBT and US was higher than that of DM, and the difference in diagnostic accuracy between DBT and DM, DBT and US, DM and US was statistically significant (all P<0.01). Conclusion DBT has obvious advantages in the detection and diagnostic accuracy of breast fibroadenoma with atypical imaging, and it could show the lesion edge more clearly than DM, so the BI-RADS classification was more benign, however, its detection and diagnostic accuracy was lower than that of US.
作者
许洪芬
林青
苏晓慧
崔春晓
费洁
李丽丽
马锦竹
XU Hongfen;LIN Qing;SU Xiaohui;CUI Chunxiao;FEI Jie;LI Lili;MA Jinzhu(Department of Breast Imaging, Affiliated Hospital of Qingdao University, Qingdao 266100, China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2019年第4期267-272,共6页
Chinese Journal of Medical Imaging
