CT平扫结合伪彩成像提高乳腺癌检出率的初步研究  

Improvement of Detection Rate for Breast Cancers on Chest CT:A Preliminary Study on Combining Pseudo Color Imaging

作　　者：敖峰[1] 高洁冰[1] 梁明柱[1] 田素伟[1] 李坤炜[1] 文燕平[1] 占莺莺 陈凯[1] 丁香莲[1] 柳学国[1] 

机构地区：[1]中山大学附属第五医院放射科,珠海519000

出　　处：《临床放射学杂志》2015年第12期1895-1899,共5页Journal of Clinical Radiology

摘　　要：目的探讨结合伪彩成像提高胸部CT平扫乳腺癌检出率的价值。方法搜集经病理证实的乳腺癌患者30例(共60只乳腺),由两名医师分别独立阅读胸部CT平扫纵隔窗图像判断是否存在乳腺癌病灶,2周后应用胸部平扫CT图像结合伪彩成像技术阅片判断是否存在乳腺癌病灶。采用Kappa方法计算两名医师的一致性,采用卡方检验验证结合伪彩成像技术可否提高胸部CT平扫乳腺癌检出率。结果纤维腺体松散分布的乳腺(Ⅰ类,13例)中,乳腺癌灶的CT值平均值高于正常腺体的CT值平均值[(21.0±13.0)HU vs(-28.1±32.8)HU](P<0.001),纤维腺体致密分布的乳腺(Ⅱ类,17例)中亦如此[(34.3±12.5)HU vs(1.9±21.7)HU](P<0.001)。在Ⅱ类乳腺中,两名医师在CT平扫图像下阅片的评价结果具有高度一致性(Kappa=0.852,P<0.001),采用CT平扫结合伪彩成像阅片方式的评价结果具有较高一致性(Kappa=0.798,P<0.001)。单纯CT平扫阅片方式及平扫结合伪彩成像阅片方式在Ⅰ类乳腺中检测乳腺癌的敏感性均为100%(13/13),平扫结合伪彩在Ⅱ类的乳腺中检测肿瘤的敏感性高于平扫阅片(94.1%vs.64.7%,P<0.05)。结论 CT平扫结合伪彩成像技术较之传统CT阅片可以提高纤维腺体致密分布的乳腺内癌灶的检出率。Objective To evaluate the usefulness of pseudo color imaging （PCI） in improving detection rate for breast cancers on chest CT images （CCI）. Methods The chest CT data of 60 breasts in 30 cases of breast cancers, which were pathologically confirmed in The Fifth Affiliated Hospital of Sun Yat Sen University from August 2011 to March 2015, were collected in this study. The breast were categorized as type Ⅰ , which were almost entirely fatty and those with scattered ar- eas of fibro glandular density, and type Ⅱ , which were heterogeneously dense and those extremely dense. The CCI were in- terpreted by two independent radiologists using mediastinal window. Two weeks later, the CCI together with PCI were inter- preted again. The Kappa test was used to evaluate the consistency of detecting breast cancers between the two radiologists, and the chi square test is used to compare the two interpretation methods. Results The mean CT attenuation of breast cancer lesions were higher than that of the normal fibro glandular breast in breast of type Ⅰ （21.0 ± 13.0 vs. - 28.1 ± 32.8, P 〈 0. 001 ） and in breast of type II （34.3 ± 12.5 vs. 1.9 ± 21.7 ,P 〈 0. 001 ）. The consistency between the two ra- diologists in detecting cancer in breast of type Ⅱ was very good by using both CCI （Kappa = 0.852）and CCI together with PCI （ Kappa = 0. 798 ）. The detection rates of breast cancer was 100% （ 13/13 ） in breast of type I by using both CCI, and CCI together with PCI, but the cancer detection rate in breast of type Ⅱ by using PCI combining with CCI was better than that of using only the CCI （94.1% vs. 64.7%, P 〈 0.05 ）. Conclusion The pseudo color imaging is a useful technique in improving the cancer detecting rate on Chest CT for the breast that are heterogeneously dense and extremely dense.

关 键 词：乳腺癌胸部 体层摄影术 X线计算机 伪彩成像 病变检出率 

分 类 号：R737.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学]