微钙化的计算机辅助检测对乳腺癌的诊断价值  

Value of computer-aided detection for microcalcification for diagnosis of breast cancer

作　　者：王金花[1] 谭婉嫦[1] 刘立志[2] 李立[2] 伍尧泮[2] 

机构地区：[1]南方医科大学附属南海医院放射科,广东528200 [2]中山大学肿瘤防治中心影像介入中心,广州510060

出　　处：《放射学实践》2013年第8期857-860,共4页Radiologic Practice

基　　金：广东省科技计划基金资助项目(2009B030801010)

摘　　要：目的:探讨基于乳腺钼靶X线片中微钙化的多特征检测的计算机辅助诊断系统(CADS)对乳腺癌的诊断价值。方法:搜集钼靶摄影检查发现钙化并经病理证实的574例患者的影像资料,其中乳腺癌321例列入乳腺癌组,良性病变253例列入良性病变组,应用CADS获取微钙化点的特征参数:种群密度、沙粒样钙化率及线样分枝状钙化率,采用ROC曲线分别分析其独立和联合诊断效能。结果:乳腺癌组微钙化上述特征参数值均高于乳腺良性病变组(P值均<0.01)。种群密度、沙粒样及线样分枝状钙化率在乳腺癌组的ROC曲线下面积分别为0.715、0.786、0.850,敏感度分别为78.6%、83.8%、86.9%,特异度分别为38.2%、50.8%、67.9%,其中线样分枝状钙化率的敏感度、特异度最高(P<0.01)。采用CADS联合检测3项特征参数,ROC曲线下面积为0.893,敏感度和特异度分别为89.8%和72.1%,均高于单项检测(P值均<0.01)。结论:检测微钙化的种群密度、沙粒样及线样分枝状钙化率对于乳腺癌的诊断有重要意义。线样分枝状钙化率对于乳腺癌的诊断效率高于其他两项参数。CADS联合检测3项参数可进一步提高诊断效率,有助于提高乳腺癌的早期检出率。Objective：To evaluate the performance of the computer aided diagnosis system （CADS） for the detection of breast cancer,based on microcalcification appearance and histopathology. Methods： The image data of 574 patients who were found microcalcifications with mammography and proved breast carcinoma （321 cases） and benign lesions （253 cases） by pathology, was detected by CADS with characteristic parameters as follows：population density, rate of fine sand-like calcification and rate of linear branching calcification. The accuracy of microcalcification detection was assessed using areas under receiver operating characteristic curves （AUCs）. Results：These parameters in malignant group were higher than the benign （P〈0.01）. ROC areas under the curve were respectively as follows：0. 715,0. 786,0. 850,with sensitivity 78.6%, 83.80%, 86.9%, and specificity, 38.2 %, 50.8%,67.9 %. Linear branching-like rate revealed the highest diagnostic efficiency （P〈0. 01）. ROC area under the curve of combined detection was 0. 893, with sensitivity of 89. 8% and specificity of 72.1 %, the result was higher than that of any single parameter （P〈0.01）. Conclusion：Combination of imaging features of microcalcifieation and CADS might contribute to the diagnosis of early breast cancer.

关 键 词：乳腺肿瘤 微钙化 诊断 X线 

分 类 号：R737.9[医药卫生—肿瘤]