全视野数字化乳腺摄影结合三维数字乳腺断层摄影对致密型乳腺肿块的诊断价值  

Diagnostic value of full-field digital mammography combined with three-dimentional digital breast tomosynthesis in the dense breast mass

作　　者：张原生[1] 王晓成[2] 王建明[1] Zhang Yuansheng;Wang Xiaocheng;Wang Jianming(Department of Radiology,Shanxi Provincial People's Hospital,Taiyuan 030012,China;Medical Record Room,Shanxi Provincial People's Hospital,Taiyuan 030012,China)

机构地区：[1]山西省人民医院放射科,太原030012 [2]山西省人民医院病案统计科,太原030012

出　　处：《肿瘤研究与临床》2019年第8期525-529,共5页Cancer Research and Clinic

摘　　要：目的探讨全视野数字化乳腺摄影(FFDM)结合三维数字乳腺断层摄影(3D-DBT)技术在致密型乳腺肿块病变中的诊断价值.方法回顾性分析山西省人民医院2018年1月至5月住院乳腺肿块患者121例(135个病灶).采用美国放射学会的乳腺影像报告和数据系统(BI-RADS)分级诊断对比分析FFDM结合3D-DBT技术与单纯使用FFDM对致密型乳腺肿块病变诊断的差别,并与病理结果进行对照分析.结果FFDM结合3D-DBT技术诊断135个病灶中,诊断乳腺癌的灵敏度为97.3%(36/37),准确率为80.0%(108/135),特异度为73.5%(72/98);FFDM诊断乳腺癌的灵敏度为86.5%(32/37),准确率为70.4%(95/135),特异度为64.3%(63/98);FFDM结合3D-DBT受试者工作特征曲线下面积(0.854)高于FFDM单独诊断(0.754).与FFDM相比,3D-DBT测量肿块直径更接近病理结果.FFDM结合3D-DBT对于肿块、毛刺特征、可疑恶性聚集钙化检出率分别为100.0%(72/72)、52.8%(19/36)、75.0%(27/36),均优于FFDM[81.9%(59/72)、41.7%(15/36)、66.7%(24/36)].结论针对致密型腺体的肿块病灶,相比单纯使用FFDM,FFDM联合3D-DBT对肿块测量的准确性、可疑病灶筛查检出率、恶性肿块毛刺征检出率及聚集微钙化检出率都有不同程度的提高.Objective To investigate the diagnostic value of full-field digital mammography (FFDM) combined with three-dimentional digital breast tomosynthesis (3D-DBT) in the lesions of dense breast mass. Methods A total of 121 patients with breast mass (135 lesions) in Shanxi Provincial People's Hospital from January 2018 to May 2018 were retrospectively analyzed. The differences of FFDM combined with 3D-DBT technique and FFDM alone in the diagnosis of dense breast mass lesions were compared and analyzed by using American Radiological Society's Breast Imaging Reporting and Data System (BI-RADS) grading diagnosis, and then the pathological results were compared. Results The sensitivity, accuracy rate and specificity of FFDM combined with 3D-DBT in the diagnosis of breast cancer among 135 lesions was 97.3% (36/37), 80.0% (108/135) and 73.5% (72/98), respectively. The sensitivity, accuracy rate and specificity of FFDM in the diagnosis of breast cancer was 86.5% (32/37), 70.4% (95/135) and 64.3% (63/98), respectively. Area under the receiver operating characteristic curve of FFDM combined with 3D-DBT was higher than that of FFDM alone (0.854 vs. 0.754). Compared with FFDM, mass diameter measured by 3D-DBT was close to the pathological results. The detection rates of mass, burr features and suspected malignant aggregation calcification by using FFDM combined with 3D-DBT were superior than those by using FFDM [100.0% (72/72) vs. 81.9% (59/72), 52.8% (19/36) vs. 41.7% (15/36), 75.0% (27/36) vs. 66.7% (24/36), respectively]. Conclusions For the focal mass of compact glands, compared with FFDM alone, the accuracy rate of the mass measurement, the detection rate of the suspected mass, the malignant mass burr, and themicro-calcification of aggregation treated by FFDM combined with 3D-DBT have been increased in a varying degree.

关 键 词：乳腺肿瘤 全视野数字化乳腺摄影 三维数字乳腺断层摄影 

分 类 号：R73[医药卫生—肿瘤]