数字乳房断层融合摄影、X线摄影及超声检查对乳腺黏液癌诊断价值比较  

DIAGNOSIS OF MUCINOUS BREAST CARCINOMA:A COMPARISON OF DIGITAL BREAST TOMOSYNTHESIS,DIGITAL MAMMOGRAPHY,AND ULTRASONOGRAPHY

作　　者：王聪聪[1] 林青[1] 崔春晓[1] 费洁[1] 苏晓慧[1] 马锦竹 WANG Congcong;LIN Qing;CUI Chunxiao;FEI Jie;SU Xiaohui;MA Jinzhu(Department of Breast Imaging, The Affiliated Hospital of Qingdao University, Qingdao 266100, China)

机构地区：[1]青岛大学附属医院乳腺影像科,山东青岛266100

出　　处：《青岛大学学报（医学版）》2018年第2期180-183,188,共5页Journal of Qingdao University(Medical Sciences)

基　　金：国家重点研发计划重大慢性非传染性疾病防控研究重点专项(2016YFC1303004)

摘　　要：目的对比分析数字乳房断层融合摄影(DBT)、数字乳房X线摄影(DM)及超声检查(US)对不同亚型乳腺黏液癌(MBC)的诊断价值。方法回顾性分析64例经手术病理证实的MBC的影像资料,其中37例为单纯型MBC,27例为混合型MBC。以2013年第5版乳房影像报告及数据系统(BI-RADS)为诊断标准,比较3种检查方法对不同亚型MBC检出率及诊断符合率的差异。结果DM、DBT及US对所有MBC的检出率分别为89.1%、96.9%、98.4%,对单纯型MBC的检出率分别为89.2%、97.3%、97.3%,对混合型MBC的检出率分别为88.9%、96.3%、100.0%,3种检查方法的检出率两两比较差异均无统计学意义(P>0.05)。DM、DBT及US对所有MBC诊断符合率分别为71.9%、93.8%、89.1%,对单纯型MBC诊断符合率分别为62.2%、91.9%、83.8%,对混合型MBC诊断符合率分别为85.2%、96.2%、96.2%。对于所有MBC及单纯型MBC,US及DBT的诊断符合率均高于DM,差异有统计学意义(χ~2=4.385~10.785,P<0.05);DBT的诊断符合率稍高于US,但差异无统计学意义(P>0.05)。对于混合型MBC,3种检查方法的诊断符合率两两比较差异均无统计学意义(P>0.05)。结论 3种检查方法对MBC的检出率差异不明显;对于MBC尤其是单纯型MBC,US及DBT的诊断符合率均高于DM,而DBT与US差异不明显。Objective To compare the diagnostic accuracy of digital breast tomosynthesis（DBT）,digital mammography（DM）,and ultrasonography（US）for different subtypes of mucinous breast carcinoma（MBC）. Methods A retrospective study was performed on the imaging data of 64 patients diagnosed with MBC by pathology.In those patients,37 had pure MBC and 27 had mixed MBC.According to the fifth version of Breast Imaging-Reporting and Data System,the detection rates of different subtypes of MBC and diagnostic accuracy were compared between the three methods. Results Using DM,DBT,and US,the detection rates of all MBC were 89.1%,96.9%,and 98.4%,respectively;the detection rates of pure MBC were 89.2%,97.3%,and97.3%,respectively;the detection rates of mixed MBC were 88.9%,96.3%,and 100.0%,respectively.There was no significant difference in the detection rate between the three methods（P〈0.05）.The diagnostic accuracy rates of DM,DBT,and US were71.9%,93.8%,and 89.1%for all MBC,62.2%,91.9%,and 83.8%for pure MBC,and 85.2%,96.2%,and 96.2%for mixed MBC,respectively.For all MBC and pure MBC,DBT and US had significantly higher diagnostic accuracy than DM（χ^2=4.385-10.785,P〈0.05）.DBT had slightly higher diagnostic accuracy than US（P〉0.05）.For mixed MBC,there was no significant difference in diagnostic accuracy between any two of the three methods（P〉0.05）. Conclusion There is no significant difference in the detection rate of MBC between the three methods.For MBC,particularly,for pure MBC,US and DBT have higher diagnostic accuracy than DM,but there is no significant difference in diagnostic accuracy between DBT and US.

关 键 词：乳房肿瘤 腺癌 黏液 乳房X线摄影术 超声检查 诊断 

分 类 号：R816.4[医药卫生—放射医学] R737.9[医药卫生—临床医学]