摘要
为了探讨对比增强能谱乳腺X线摄影(CESM)的强化特点及其对乳腺影像报告和数据系统(BI-RADS)4类乳腺病灶的鉴别价值,本文收集了CESM检查中诊断为BI-RADS 4类的患者60例,经病理结果证实,共检出60个病灶,其中有27个恶性病灶,33个良性病灶。测量了CESM中病灶在头尾位(CC)、内外斜位(MLO)和背景兴趣区(ROI)的信号值,计算病灶与背景的差异百分比(RS%)和对比噪声比(CNR);根据病灶在两个体位强化程度差值,将病灶的强化类型分为:流入型(Ⅰ型)、平台型(Ⅱ型)、流出型(Ⅲ型),分析了良/恶性组间强化程度和强化类型差异。结果显示,良恶性病灶的差异百分比和对比噪声比的差异无统计学意义。Ⅰ型病灶中87%为良性,13%为恶性;Ⅱ型病灶中55.6%为良性,44.4%为恶性;Ⅲ型病灶中15.8%为良性,84.2%为恶性。良性病灶常表现为Ⅰ型、Ⅱ型,恶性病灶常表现为Ⅱ型、Ⅲ型,差异有统计学意义。总之,CESM强化类型分析能对诊断为BI-RADS 4类病灶的良恶性鉴别提供一定依据。
The purpose of the study is to explore the enhancement characteristics of contrast-enhanced spectral mammography and its diagnostic effect for breast imaging reporting and date system(BI-RADS)category 4breast lesions.60patients whose lesions were categorized as BI-RADS 4in CESM examination were recruited,and a total of 60lesions were detected using pathology results as the gold standard,including 27malignant lesions and 33benign lesions.Signal values of ROI in CESM were measured,including lesions of craniocaudal(CC),mediolateral obliqde(MLO)and background,then percentage difference(RS%)and contrast noise ratio(CNR)between lesions and background were calculated.According to the enhancement difference of lesions between two postures,the enhancement types were divided into:persistent(typeⅠ),plateau(typeⅡ),and washout(typeⅢ).The difference of intensification degree and intensification type between the benign and malignant groups were compared,respectively.The results showed that there was no significant difference in RS%and CNR between malignant and benign lesions(P>0.05).87%lesions were benign and 13%were malignant in typeⅠ,55.6%were benign and 44.4%were malignant in typeⅡ,15.8%were benign and 84.2%were malignant in typeⅢ.Benign lesions were usually of typeⅠand typeⅡ,and malignant lesions were of typeⅡand typeⅢ.The difference between two groups was statistically significant.In conclusion,the enhanced type analysis could provide certain basis for identifying the benign and malignant types of BI-RADS category 4lesions in CESM.
作者
杨行
李真林
张雪琴
杨吉学
周蜀川
刘莹
赵爽
袁元
YANG Hang;LI Zhenlin;ZHANG Xueqin;YANG Jixue;ZHOU Shuchuan;LIU Ying;ZHAO Shuang;YUAN Yuan(Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,P.R.China)
出处
《影像科学与光化学》
CAS
2020年第5期876-881,共6页
Imaging Science and Photochemistry
