摘要
目的:探讨锥光束乳腺CT(CBBCT)扫描技术在肿块型病变良恶性鉴别诊断价值。方法:本研究分析行CBBCT平扫及增强扫描并符合病例纳入标准患者24例(共40个病灶),其中良性组9例(12个病灶),恶性组15例(28个病灶)。统计平扫、增强扫描病灶检出率,分析比较良、恶性组增强形态学征象及时间-密度曲线特点,统计分析平扫未检出组与检出组病灶最大径、良性组和恶性组增强参数有无统计学差异。结果:40个病灶平扫检出率和增强检出率分别为23/40、40/40,平扫检出组病灶最大径>未检出组(2.76±1.54cm vs 1.31±0.58cm)且差异有统计学意义。良、恶性组时间-密度曲线形态不同,良性组以缓慢上升和缓慢平台型为主(10/12),恶性组以中等/快速平台型和快速流出型为主(24/28)。恶性组增强第1期CT值和增强1期强化率高于良性组(190.86±59.80Hu vs 120.77±59.78Hu;151.00%±1.17 vs 19.41%±0.15),而增强2期强化率低于良性组(-2.95%±0.13 vs 16.56%±0.22)且差异有统计学意义;以上3个增强参数ROC曲线下面积分别为0.804、0.994、0.217(增强1期强化率诊断效能最高,最佳诊断阈值53.81%)。结论:CBBCT增强检查较平扫能提高病变检出率且增强形态学征象及增强参数有助于提高乳腺癌与良性病变鉴别诊断准确性。
Objective:To explore the value of cone beam breast CT(CBBCT)in differential diagnosis of benign and malignant mass lesions.Methods:This study retrospectively analyzed 24 patients(40 lesions)who underwent CBBCT scan,including 9 cases in the benign group(12 lesions)and 15 cases in the malignant group(28 lesions).The detection rate of lesions in unenhanced and contrast-enhanced was statistically analyzed,and the enhancement morphological signs and time-density curve characteristics of benign and malignant groups were compared.and also analyze the statistical differences between the undetected group and the detected group with the maximum diameter of the lesion in plain scan,and the enhancement parameters between the benign group and the malignant group.Results:The detection rate of 40 lesions on unenhanced and contrast-enhanced scan were 23/40 and 40/40,respectively.The difference was statistically significant in the undetected group and the detected group(2.76±1.54cm vs 1.31±0.58cm)with maximum diameter in plain scan.The time-density curves of benign and malignant groups were different in morphology.The benign group was mainly slow-rising or slow-plateau type(10/12),while the malignant group was mainly medium or fast-plateau type and fast-outflow type(24/28).The CT value and enhancement rate of the first enhanced phase in the malignant group were higher than that of the benign group(190.86±59.80HU vs 120.77±59.78HU;151.00%±1.17 vs 19.41%±0.15),while the enhancement rate in the second enhancement stage was lower than that in the benign group(-2.95%±0.13 vs 16.56%±0.22),and the difference was statistically significant.The area under ROC curve of the above three enhancement parameters was 0.804,0.994 and 0.217 respectively(the diagnostic efficiency of the enhancement rate in the first enhancement phase was the highest,and the optimal diagnostic threshold was 53.81%).Conclusion:Compared with plain scan,enhanced CBBCT can improve the detection rate of lesions and enhanced morphological signs and enhancement para
作者
赵欣
苏丹柯
康巍
金观桥
刘宇
郑仲涛
蒙丽宇
黄富玲
ZHAO Xin;SU Dan-ke;KANG Wei(Department of Radiology,the Affiliated Cancer Hospital of Guangxi Medical University,Nanning 530021,China)
出处
《放射学实践》
北大核心
2020年第10期1268-1273,共6页
Radiologic Practice
基金
国家重点研发项目(2017YFC0112600,2017YFC0112603)
广西高校中青年教师科研基础能力提升项目(2019KY0140)
广西影像医学临床医学研究中心
广西临床重点专科(医学影像科)
广西医科大学附属肿瘤医院优势培育学科(医学影像科)。
