摘要
目的 探讨对比增强能谱X线摄影(CESM)定量分析对于肿块型乳腺病变的诊断价值。方法 回顾性分析临床、X线摄影或超声检查可疑恶性肿块行CESM检查的177例患者临床影像资料。通过与病理结果对照,采用t检验和χ^(2)检验比较良恶性肿块强化程度(%RS)和强化曲线的差异,使用受试者工作特征(ROC)曲线分析其诊断效能。CESM与MRI增强曲线的一致性采用Kappa检验进行分析。结果 恶性肿块的%RS平均值为(4.5±1.9)%,良性肿块%RS平均值为(3.1±1.6)%,两者间差异存在统计学意义(P<0.001)。CESM强化程度鉴别肿块良恶性的ROC曲线下面积(AUC)为0.739(P<0.001)。恶性肿块中,Ⅲ型曲线占70.9%,Ⅱ型曲线29.1%,Ⅰ型曲线0%;良性肿块中,Ⅰ型曲线45.8%,Ⅱ型曲线40.3%,Ⅲ型曲线13.9%。强化曲线在良恶性肿块中的分布差异存在统计学意义(P<0.001)。CESM强化曲线诊断肿块良恶性的AUC为0.852,与强化程度的AUC比较,差异存在统计学意义(P<0.001)。CESM与MRI对于强化曲线判断的一致性良好(Kappa=0.708)。结论 CESM定量分析对于乳腺肿块良恶性鉴别有着较高的诊断价值。与乳腺良性肿块相比,恶性肿块强化程度更高,曲线更多表现为Ⅲ型。
Objective To explore the diagnostic value of quantitative analysis of contrast-enhanced spectral mammography for enhanced benign and malignant breast mass lesions.Methods One hundred and seventy-seven patients who were suspected of breast masses by clinical,mammography or ultrasound examination in our hospital from April 2019 to January2021 were retrospective collected.Using pathological results as the gold standard,ttest and χ^(2)test were used to compared the difference of enhancement degree(%RS)and enhancement curve between benign and malignant tumors.Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy.The consistency of enhancement curve between CESM and MRI was analyzed byKappatest.Results Mean%RS was (4.5±1.9)%in malignant masses,while in benign masses,mean%RS was (3.1±1.6)%.The difference was statistically significant (P<0.001).The area under ROC curve (AUC) was 0.739 (P<0.001).The distribution of curve types for malignant masses was typeⅢ,70.9%;typeⅡ,29.1%;and typeⅠ,0%.The distribution of curve types for benign masses was typeⅠ,45.8%;typeⅡ,40.3%;and typeⅢ,13.9%.The distributions proved significantly different(P<0.001).The AUC of enhancement curve in the diagnosis of benign and malignant masses was 0.852,which was significantly different from that of enhancement degree (P<0.001).There was a good agreement for the judgment of the enhancement curve between CESM and MRI (Kappa=0.708).Conclusion The quantitative analysis of enhancement on CESM has a high diagnostic efficacy in the differential diagnosis of benign and malignant breast masses.The malignant masses have stronger enhancement and more type Ⅲ enhancement pattern than the benign masses.
作者
荣小翠
康一鹤
薛晶
李智岗
韩捧银
杨光
李亚男
RONG Xiaocui;KANG Yihe;XUE Jing(Department of Radiology,the Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei Province 050011,P.R.China)
出处
《临床放射学杂志》
北大核心
2022年第3期445-449,共5页
Journal of Clinical Radiology
基金
河北省科学技术厅重点研发计划资助项目(编号:20377783D)
河北省医学科学研究重点课题(编号:20210838)。
关键词
对比增强能谱X线摄影
乳腺肿瘤
肿块
定量分析
Contrast-enhanced spectral mammography
Breast neoplasms
Mass
Quantitative analysis
