乳腺X线及CT成像在乳腺分叶状肿瘤分级中的应用  

Application of Mammography and CT Imaging in Classification of Breast Phyllodes Tumor

作　　者：潘兆春 张翔 王荣洲 张鸽 丁媛媛 崔文静 PAN Zhaochun;ZHANG Xiang;WANG Rongzhou;ZHANG Ge;DING Yuanyuan;CUI Wenjing(Department of Outpatient,Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Provincial Hospital of Chinese Medicine),Nanjing Jiangsu 210029,China;Department of Radiology,Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Provincial Hospital of Chinese Medicine),Nanjing Jiangsu 210029,China)

机构地区：[1]南京中医药大学附属医院(江苏省中医院)门诊部,江苏南京210029 [2]南京中医药大学附属医院(江苏省中医院)放射科,江苏南京210029

出　　处：《中国医疗设备》2020年第10期117-121,共5页China Medical Devices

摘　　要：目的探讨乳腺X线及CT成像鉴别乳腺分叶状肿瘤G1级与G2/G3级的影像特征,并比较两种方法的诊断效能。方法本研究搜集了于我院经手术病理证实的80例乳腺分叶状肿瘤,对其中符合纳入标准的45例乳腺X线及40例CT从临床、X线及CT征象进行评估。应用卡方检验及受试者工作特征(Receiver Operating Characteristic,ROC)曲线评价有意义的特征及两种影像学方法的诊断效能。结果当X线及CT上肿瘤直径分别大于4 cm及3.25 cm时,提示为G2/G3级肿瘤,P=0.025、0.05。高级别肿瘤更易呈现深分叶或多结节融合状,P值为0.004及0.046。CT上肿瘤的边界、均匀性对于分级的鉴别P值为0.018及0.016。X线对于分叶状肿瘤的分级鉴别曲线下面积达0.831(敏感性74.2%,特异性85.7%),CT检查曲线下面积达0.834(敏感性72.4%,特异性81.8%)。结论乳腺X线及CT成像均对乳腺分叶状肿瘤的良恶性鉴别有一定价值且效能相近,根据患者情况选择任意一种检查,均可为手术方案的选择提供术前参考。Objective To explore the imaging features of breast X-ray and CT imaging in differentiating G1 and G2/G3 breast lobulated tumors,and to compare the diagnostic efficacy of the two methods.Methods In this study,80 cases of phyllodes tumor of breast confirmed by operation and pathology in our hospital were collected.Among them,45 cases of mammography and 40 cases of CT were evaluated according to the clinical,X-ray and CT features.Chi square test and receiver operating characteristic(ROC)curve were used to evaluate significant features and diagnostic efficacy of the two imaging methods.Results When the diameter of the tumor on X-ray and CT was larger than 4 cm and 3.25 cm respectively,it indicated that the tumor was G2/G3 grade,P=0.025,P=0.05.High grade tumors were more likely to show deep lobulation or multi nodule fusion(P=0.004 and 0.046).The P values of boundary and uniformity of tumor on CT were 0.018 and 0.016,respectively.The area under the ROC curve of X-ray was 0.831(sensitivity 74.2%,specificity 85.7%),and CT was 0.834(sensitivity 72.4%,specificity 81.8%).Conclusion Both mammography and CT imaging have a certain value in the differentiation of benign and malignant breast phyllodes tumors and have similar efficacy.Choose any examination according to the patient’s condition,which can provide a preoperative reference for the selection of surgical options.

关 键 词：乳腺X线检查 CT 分叶状肿瘤 良恶性鉴别 

分 类 号：R737.9[医药卫生—肿瘤]