自动乳腺全容积扫查与增强磁共振成像诊断乳腺病灶对比研究  

Comparation of automated breast volume scanner and MRI in diagnosis of breast masses

作　　者：金叶[1] 李凤华[1] 杜晶[1] 王琳[1] 万财凤[1] 

机构地区：[1]上海交通大学医学院附属仁济医院超声科,上海200127

出　　处：《中国医学影像技术》2015年第3期409-412,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的比较自动乳腺全容积扫查(ABVS)与MRI诊断乳腺病灶的价值。方法收集乳腺肿块患者70例,共77个病灶,均经手术后病理证实。分析其ABVS和MRI图像特征,并比较二者评估乳腺病灶大小和诊断病灶良恶性的效能,评估ABVS冠状面上的"汇聚征"对乳腺恶性肿块的诊断效能。结果 70例患者中,良性37例(共43个病灶),恶性33例(共34个病灶)。ABVS[(18.0±8.9)mm]和MRI[(17.0±9.0)mm]测得病灶最大值与病理测值[(17.8±9.2)mm]均呈正相关(r=0.96、0.95,P<0.01),但ABVS和MRI所测病灶最大值差异无统计学意义(P>0.05)。ABVS和MRI诊断乳腺肿块的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为91.18%(31/34)和85.29%(29/34)、86.05%(37/43)和90.70%(39/43)、88.31%(68/77)和88.31%(68/77)、83.78%(31/37)和87.88%(29/33)、92.50%(37/40)和88.64%(39/44),ROC曲线下面积分别为0.96、0.95(P>0.05)。"汇聚征"阳性率为32.47%(25/77),在良、恶性病灶中分别占6.98%(3/43)和64.71%(22/34),差异有统计学意义(2χ=6.87,P<0.01)。ABVS重建冠状面"汇聚征"对乳腺肿瘤良恶性鉴别诊断的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为64.70%(22/34)、93.02%(40/43)、80.52%(62/77)、88.00%(22/25)和76.92%(40/52)。结论 ABVS和MRI均能有效诊断乳腺肿块,但ABVS对乳腺肿块的诊断敏感度更高,其冠状面的"汇聚征"能有效鉴别乳腺肿块的良恶性。Objective To compare the value of automated breast volume scanner（ABVS）with that of MRI in diagnosis of breast masses.Methods Seventy patients（77masses）with breast masses were enrolled and confirmed by the postoperative pathology.The image features of ABVS and MRI were analyzed and the effectivity of ABVS and MRI in evaluating the size and nature（benign/malignant）of breast lesion were compared,and then the effectivity of retraction phenomenon of breast masses on ABVS coronal plane in differential diagnosis of benign and malignant lesions were analyzed.Results Of the 70 patients,37lesions（43masses）were benign,33lesions（34masses）were malignant.The maximum size measured by ABVS（[18.0±8.9]mm）and MRI（[17.0±9.0]mm）were both positively correlated to the maximum size measured by pathology（[17.8±9.2]mm,r=0.96,0.95,P〈0.01）,and there was no statistical difference between ABVS and MRI（P〉0.05）.The sensitivity,specificity,accuracy,positive predictive value（PPV）and negative predictive value（NPV）of ABVS and MRI for the diagnosis of breast masses were91.18%（31/34）and 85.29%（29/34）,86.05%（37/43）and 90.70%（39/43）,88.31%（68/77）and 88.31%（68/77）,83.78%（31/37）and 87.88%（29/33）,92.50%（37/40）and 88.64%（39/44）,and the area under the ROC curve was 0.96 and 0.95（P〉0.05）,respectively.The positive rate of retraction phenomenon was 32.47%（25/77）,and it was 6.98%（3/43）in benign lesions and 64.71%（22/34）in malignant lesions,the difference was statistically significant（χ^2=6.87,P〈0.01）.The sensitivity,specificity,accuracy,PPV and NPV of the retraction phenomenon for breast lesions were 64.70%（22/34）,93.02%（40/43）,80.52%（62/77）,88.00%（22/25）and 76.92%（40/52）.Conclusion ABVS and MRI are effective in the diagnosis of breast masses,but the sensitivity of ABVS is higher than that of MRI,retraction phenomenon on coronal plane is useful for the diagnosis of breast diseases.

关 键 词：乳腺肿瘤 自动乳腺全容积扫查 磁共振成像 汇聚征 

分 类 号：R445[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]