超声及热层析成像检查对乳腺导管内原位癌诊断价值的对比研究  

A comparative study of the diagnostic value of ultrasonography and thermal tomography in the diagnosis of breast ductal carcinoma in situ

作　　者：史曼曼 李怡璇 李娟娟[1] 吴奇[1] 李凯扬[3] 孙圣荣[1] SHI Manman;LI Yixuan;LI Juanjuan;WU Qi;LI Kaiyang;SUN Shengrong(Dept. of Breast and Thyroid Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China;Dept. of Ultrasonography,West China Hospital of Sichuan University,Chengdu 610041,Sichuan,China;School of Physics and Technology,Wuhan University,Wuhan 430072,Hubei,China)

机构地区：[1]武汉大学人民医院乳腺甲状腺外科,湖北武汉430060 [2]四川大学华西医院超声科,四川成都610041 [3]武汉大学物理科学与技术学院,湖北武汉430072

出　　处：《武汉大学学报（医学版）》2019年第1期91-96,共6页Medical Journal of Wuhan University

基　　金：国家重大科学仪器设备开发专项(编号:2012YQ160203)

摘　　要：目的:探讨超声和热层析成像对乳腺导管内原位癌(DCIS)的诊断效果,以及不同医院的两种影像学方法之间的诊断效能差异。方法:回顾性分析2014年1月-2017年3月在武汉大学人民医院和四川大学华西医院经病理确诊为DCIS的病人以及同期良性对照病例,并根据入组医院不同分为N1和N2组,分别纳入73、76例病人,收集所有病人的超声及热层析资料进行对照研究。结果:149例病人中热层析诊断的灵敏度为85.8%、特异度98.75%、准确率为92.6%,均优于超声,有统计学意义(P=0.000)。超声联合热层析检出效能相对于单独热层析检查没有体现显著优势。对于两组间比较,N1组超声诊断灵敏度优于N2组(69.7%vs44.4%,χ^2=4.468,P=0.035),而热层析成像检出灵敏度、特异度、准确率均无统计学差异。结论:热层析成像在乳腺DCIS疾病中的检出效果明显优于超声,且不同于超声对于操作者经验与能力的依赖性,热层析成像可以比较客观的做出诊断,为DCIS的早期筛查与诊断提供了新的选择。Objective: To investigate the diagnostic value of ultrasonography and thermal tomography in ductal carcinoma in situ(DCIS) and the difference in diagnostic efficiency between the two imaging methods in different hospitals. Methods: We retrospectively analyzed the patients diagnosed as DCIS by pathology between Renmin Hospital of Wuhan University and West China Hospital of Sichuan University from January 2014 to March 2017. We also selected benign cases in the same period as controls.According to the different hospitals, they were divided into N1 and N2 groups with 73 and 76 patients in each group respectively. Ultrasonography and thermal tomography data were collected fromall patients for controlled study. Results: The diagnostic sensitivity, specificity, and accuracy of thermal tomography in 149 patients were 85.8%, 98.75%, and 92.6%, respectively, which were superior to those of ultrasonography(P=0.000). Ultrasonography combined with thermal tomography showed no significant advantage over the separate thermal tomography examination. For the comparison between the two groups, the ultrasonography diagnosis sensitivity of N1 group was better than that of N2 group(69.7% vs 44.4%,χ2=4.468, P=0.035). In addition, there was no statistical difference in sensitivity, specificity, or accuracy in the comparison of thermal tomography between the two groups. Conclusion: Thermal tomography is significantly more accurate than ultrasonography in diagnosing DCIS and differes from the dependence of ultrasonography on the operator’s experience and ability. Thermal tomography could make a relatively objective diagnosis. Thermal tomography provides new options for early screening and diagnosis of DCIS.

关 键 词：乳腺导管内原位癌 热层析成像 超声 

分 类 号：R445.7[医药卫生—影像医学与核医学]