探讨数字乳腺三维断层融合与X线摄影在致密型乳腺诊断中的剂量差异及临床运用价值  

Exploration of the Dose Difference and Clinical Application Value of Digital Breast Three-Dimensional Tomographic Fusion and X-Ray Photography in the Diagnosis of Dense Breast

作　　者：周蜀川 张雪琴[1] 王紫薇[1] 杨行[1] ZHOU Shuchuan;ZHANG Xueqin;Wang Ziwei;YANG hang(Department of Radiology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,China)

机构地区：[1]四川大学华西医院放射科,四川成都610041

出　　处：《中国医疗设备》2020年第4期75-78,共4页China Medical Devices

摘　　要：目的探讨数字乳腺三维断层融合技术(Digital Breast Tomosynthesis,DBT)与全视野数字化乳腺X线摄影(Full-Field Digital Mammography,FFDM)在致密型乳腺诊断中的剂量差异及临床运用价值。方法回顾性分析临床确诊乳腺患者134例,患者均进行FFDM和DBT检查,采用常规头尾位及内外侧斜位,按操作规范对乳腺进行压迫,并在相同压迫状态下进行摄影。对FFDM和DBT图像进行独立诊断,比较两者在辐射剂量差异及对腺体内病变的筛查能力。结果DBT+VPreview的敏感度为88.57%(31/35),特异度为80.81%(80/99),准确率为82.83%(111/134);FFDM的敏感度为57.14%(20/35),特异度为57.14%(20/35),准确率为58.95%(79/134)。在对肿块进行BI-RADS分类及病灶大小测量的准确性方面,DBT明显优于FFDM,差异有统计学意义(χ^2=10.647、8.741、18.518,P<0.001)。在致密型腺体中DBT能减少组织重叠,且患者所受辐射剂量相当。结论对致密型乳腺患者进行病变筛查时可优先选用DBT。Objective To explore the dose difference and clinical application value of 3D digital breast tomosynthesis(DBT)and fullfield digital mammography(FFDM)in the diagnosis of dense breast.Methods A total of 134 cases of clinically confirmed breast patients were analyzed retrospectively.All patients completed FFDM and DBT imaging.The breasts were compressed according to the operating specifications using the cranoocaudal view and the mediolateral oblique view,and photographed under the same compression state.FFDM and DBT images were diagnosed independently,and the difference of radiation dose between them and the ability of screening intraglandular lesions were compared.Results The sensitivity of DBT+V-preview was 88.57%(31/35),specificity 80.81%(80/99),and accuracy 82.83%(111/134);The sensitivity of FFDM was 57.14%(20/35),specificity 57.14%(20/35),and accuracy 58.95%(79/134).In terms of the accuracy of BI-RADS classification and measurement of tumor size,DBT was better than FFDM and the difference was statistically significant(χ^2=10.647,8.741,18.518;P<0.001).DBT could reduce tissue overlap in dense glands,and the radiation dose of patients was equivalent.Conclusion DBT can be selected preferentially in the screening of dense breast disease.

关 键 词：乳腺三维断层融合技术 致密型乳腺 乳腺X线摄影 辐射剂量 

分 类 号：R144[医药卫生—公共卫生与预防医学] R737.9