数字乳腺断层摄影在乳腺结构扭曲征象中的应用  

Application value of digital breast tomosynthesis(DBT) in diagnosis for breast architectural distortion

作　　者：胡明芳[1] 张惠美[1] 杨君[1] 田萍[1] 吴晓[1] 徐华军[2] 邵霞[3] HU Mingfang;ZHANG Huimei;YANG Jun;TIAN Ping;WU Xiao;XU Huajun;SHAO Xia(Department of Radiology,Huzhou Central Hospital in Zhejiang Province,Huzhou 515000,China;Department of Ultrasound,Huzhou Central Hospital in Zhejiang Province,Huzhou 313000,China;Department of Surgery,Huzhou Central Hospital in Zhejiang Province,Huzhou 313000,China)

机构地区：[1]浙江省湖州市中心医院放射科,浙江湖州313000 [2]浙江省湖州市中心医院超声科,浙江湖州313000 [3]浙江省湖州市中心医院外科,浙江湖州313000

出　　处：《中国现代医生》2018年第23期122-125,共4页China Modern Doctor

基　　金：浙江省科技计划项目(2018C37089)

摘　　要：目的探讨数字乳腺断层摄影(DBT)在乳腺结构扭曲征象上的诊断应用价值。方法 66例钼靶X线摄影存在乳腺结构扭曲征象的患者行数字乳腺断层摄影,以MRI为对照,对其影像学特征进行分析并比较两者诊断的敏感性、特异性及阳性预测值差异。结果 DBT和MRI乳腺腺体分类均以c型和d型为主,两组病例腺体类型分布比较,差异无统计学意义(χ~2=0.23,P=0.63),MRI应用BI-RADS分类诊断系统对乳腺结构扭曲诊断效能高于DBT(χ~2=23.92,P<0.001),MRI诊断敏感性高于DBT(χ~2=4.45,P=0.03),而DBT与MRI诊断的特异性及阳性预测值比较,差异无统计学意义(P>0.05)。结论钼靶X线摄片中发现的乳腺结构扭曲DBT是首选的检查方法,对于DBT表现不典型,则行MRI作进一步检查。Objective To explore the application value of digital breast tomosynthesis （DBT） in diagnosis for breast ar- chitectural distortion. Methods 66 patients whose Mo-target X-ray photography had showed the existence of breast ar- chitectural distortion were detected by DBT with MRI results as control. The imaging features and compared the sensi- tivity, specificity and positive predictive value of these two methods were analyzed. Results The main types of mam- mary gland in the images of DBT and MRI were type C and D. There was no significant difference in the type distribu tion of mammary gland between the image of DBT and that of MRI（x2=0.23, P=0.63）. The diagnostic efficiency of MRI with BI-RADS classification system was higher than that of DBT（x2=23.92, P=0.001）. The diagnosis sensitivity of MRI was higher than that of DBT （X2=4.45, P=0.03）. However, there was no significant difference in the specificity and positive predictive value between MRI and DBT（P〉0.05）. Conclusion DBT is a preferred detective method for breast architectural distortion that can be discovered in Mo-target X-ray photography. If the image of DBT is not typi- cal, MRI should be done for further examination.

关 键 词：结构扭曲 数字乳腺断层摄影 MRI 乳腺癌 致密型乳腺病变 

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