摘要
目的研究数字乳腺断层摄影（DBT）与全数字化乳腺摄影（FFDM）对致密型乳腺病变特征的显示效果，以及FFDM检查、FFDM结合DBT检查诊断致密型乳腺病变的准确性，评价DBT诊断致密型乳腺病变的价值。方法选择致密型乳腺患者134例，分别采用FFDM、FFDM结合DBT进行独立诊断，以病理诊断作为金标准，评价FFDM、FFDM结合DBT诊断致密型乳腺病变的准确性。比较FFDM和DBT显示的病变特征以及肿块型病变的最长径。结果134例患者中，良性病变69例，恶性病变65例。65例恶性病变中，DBT和FFDM检出毛刺征分别为30例和14例。在69例良性病变中，DBT和FFDM检出肿物边缘清楚分别为46例和33例。DBT检查显示血管穿人征3例。在3型乳腺中，FFDM与DBT检查毛刺征的检出率比较，差异有统计学意义（P〈0．05）；边缘清楚和血管征的检出率差异均无统计学意义（均P〈0．05）。在层厚1mm时，63．9％（23／36）的DBT与FFDM显示钙化的效果相似，5．6％（2／36）的DBT显示效果优于FFDM，30．6％（11／36）显示效果差于FFDM；FFDM与DBT显示钙化的效果差异有统计学意义（P〈0．05）。当改变层厚为1cm时，二者显示钙化的效果差异无统计学意义（P〉0．05）。DBT测量肿块型病变最长径为（2．46±1．64）cm，FFDM测量最长径为（2．58±1．62）cm，二者差异有统计学意义（P〈0．05）。FFDM、FFDM结合DBT诊断病变的准确性分别为88．8％和91．8％。以病理诊断作为金标准，FFDM诊断的ROC曲线下面积（AUC）为0．887，FFDM结合DBT诊断的AUC值为0．918。结论对致密型乳腺疾病的诊断，DBT在显示病变的形态特征和微小钙化方面，具有一定的优势。FFDM结合DBT对提高病变诊断的准确性并不显著。
Objective To compare the performance of full-field digital mammography （FFDM） and digital breast tomosynthesis （DBT） in the assessment of the lesions in dense breast, and to estimate the difference in diagnosis of breast disease by FFDM images alone and FFDM plus DBT images. Methods According to the breast imaging reporting and data system （ BIRADS）, 134 patients were selected. The morphology of the lesions shown on FFDM and DBT were evaluated and compared, and the maximum diameter of the lesions was measured. At first, doctors made the diagnosis of a patient by reading FFDM only. Then they made another diagnosis by combining with DBT images of the same patient. The two diagnoses were compared and analyzed according to the pathology results. Results One hundred and thirty- four patients were included in this study, and all of them were confirmed by histology （65 benign cases, 69 malignant cases）. DBT could show more details about the morphology of the lesions, including the border of the masses, spiculation and vessels. The numbers of those signs detected by DBT were 46, 30 and 3, respectively, while only 33 case with circumscribed masses and ld cases with spiculation were detected by FFDM. Only the difference of spiculation in heterogeneously dense breast detected by DBT and FFDM was statistically significant （P 〈 O. 05）. Of the cases with calcifications, DBT images （ reconstructed as a 1-mm-thick slice） showed calcifications superior to FFDM in 2 cases, equal to FFDM in 23cases, and inferior to FFDM in 11 cases. The difference was statistically significant （ P 〈 0.05）. But when thickness was changed into 1 era, the visibility of calcifications in those cases was equal between FFDM and DBT. The maximum diameter of lesions was 2.46 ~ 1.64 cm in DBT image, and 2.58 -＋ 1.62 cm in FFDM image, with a significant difference （ P 〈 0. 05 ）. Comparing with reading FFDM images only, the accuracy of FFDM combining with DBT was increased from 88.8% to 91.8%. For FFDM, the AUC of ROC was 0. 887, while for DBT it was increased to 0. 912, with a non-significant difference （P 〉 0. 05）. Conclusions DBT is superior to FFDM in the morphological characterization and small calcification in the lesions in dense breast. Combining FFDM and DBT inmroves the accuracy of diatmosis, but the difference is not statistically significant.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2013年第1期33-37,共5页
Chinese Journal of Oncology
关键词
数字乳腺断层摄影
全数字化乳腺摄影
乳腺疾病
诊断
Digital breast tomosynthesis
Full-field digital mammography
Breast diseases
Diagnosis
