摘要
目的基于敏感性、特异性等指标的评价,探讨数字乳腺X线摄影及超声对男性乳腺病变的诊断价值。方法选取79例行乳腺X线摄影检查的男性乳腺肿块病例,部分病例同时行超声检查(62例)。乳腺病灶评价依据2013版BI-RADS,通过2位高年资乳腺放射医师对征象进行分析后作出BI-RADS分类,并将BI-RADS 4a类以上定义为阳性,以病理结果为金标准,最终评价数字乳腺X线摄影及超声对男性乳腺病变的诊断效能。结果1)79例男性乳腺病变,年龄16~83岁,平均年龄53.9岁,中位年龄56.0岁。临床触诊阴性4例,单侧包块61例(右侧25例,左侧36例),双侧包块13例,溢血1例;2)数字乳腺X线摄影的BI-RADS分类为:2类61例,3类6例,4a类3例,4b类1例,4c类3例,5类5例。62例乳腺超声BI-RADS分类为:0类5例,1类1例,2类39例,3类3例,4a类5例,4b类2例,4c类5例,5类2例。其中超声诊断为0类的5例病例,在乳腺X线摄影中BI-RADS分类分别为2类3例,3类2例;3)数字乳腺X线摄影检查对男性乳腺疾病的敏感性100%,特异性94.4%,阳性预测值66.7%,阴性预测值100%,ROC曲线下面积为0.972;乳腺超声检查对男性乳腺疾病的敏感性100%,特异性79.6%,阳性预测值42.1%,阴性预测值100%,ROC曲线下面积为0.898。结论数字乳腺X线摄影及乳腺超声对男性乳腺疾病均具有较高的诊断效能,尤其数字乳腺X线摄影在敏感性、特异性方面表现出更为显著的优势,并且在BI-RADS分类方面更为准确。在剂量允许的基础上,对于男性乳腺疾病患者,数字乳腺X线摄影可作为一种推荐检查方法。
Objective To explore the diagnostic value of digital mammography and breast ultrasound in male breast lesions based on the evaluation of diagnostic efficacy,including sensitivity,specificity and other indicators.Methods The cases of male breast masses undergoing mammography were retrospectively collected,and a total of 79 cases were finally included,with some cases also undergoing breast ultrasonography,for a total of 62 cases.Breast lesions were evaluated according to the 2013 edition of the breast imaging reporting and data system(BI-RADS).The signs were analyzed by two senior breast radiologists,and the image BI-RADS classification was made.According to the clinical practice,BI-RADS4a or above was considered positive,and the pathological results were used as the gold standard to finally evaluate the diagnostic efficacy of digital mammography and breast ultrasound for male breast lesions.Results 1)There were 89 cases of male breast lesions,aged from 16 to 83 years,with a mean age of 53.9 years and a median age of 56.0 years;2)The BI-RADS category of digital mammography was 61 cases of category 2,6 cases of category 3,3 cases of category 4a,1 case of category 4b,3 cases of category 4c,and 5 cases of category 5.There were 62 cases of breast ultrasound,and the BI-RADS category was 5 cases of category 0,1 cases of category 1,39 cases of category 2,3 cases of category 3,5 cases of category 4a,2 case of category 4b,5 cases of category 4c,and 2 cases of category 5.Among them,5 cases were diagnosed as category 0 by ultrasound.In mammography,the BI-RADS category was 3 cases in category 2 and 2 cases in category 3 and 1;3)Digital mammography had a sensitivity of 100%,specificity of 94.4%,positive predictive value of 66.7%,negative predictive value of 100%,and area under the ROC curve of 0.972 for male breast disease;breast ultrasound had a sensitivity of 100%,specificity of 79.6%,positive predictive value of 42.1%,negative predictive value of 100%,and area under the ROC curve of 0.898 for male breast disease.Conclusion Both digital mammography and breast ul-trasound have high diagnostic efficacy for male breast diseases.In particular,digital mammography shows more significant advantages in sensitivity and specificity,and is more accurate in BI-RADS category.Digital mammography can be used as a recommended examination method for men with breast disease on a dose allowable basis.
作者
曾辉
徐泽园
曾凤霞
徐维敏
文婵娟
陈卫国
ZENG Hui;XU Zeyuan;ZENG Fengxia;XU Weimin;WEN Chanjuan;CHEN Weiguo(Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, P.R.China)
出处
《医学影像学杂志》
2022年第1期42-45,共4页
Journal of Medical Imaging
基金
广东省医学科研基金项目(编号:B2020095)
南方医科大学南方医院院长基金项目(编号:2017C040)
南方医科大学南方医院临床研究专项项目(编号:2019CR002,2019CR003)。
