X线摄影联合导丝定位切除术在BI-RADS 4类钙化中的应用  

Application of mammography combined with wire-guided localization and excision in BI-RADS 4 calcification lesions

作　　者：沈俊杰[1,2] 王祥芝 杨菊萍 汤晓敏 高之振[1,2] 陈自谦 SHEN Junjie;WANG Xiangzhi;YANG Juping;TANG Xiaomin;GAO Zhizhen;CHEN Ziqian(Department of Radiology,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui Province 233000,China;School of Medical Imaging,Bengbu Medical College,Bengbu,Anhui Province 233000,China;Department of Medical Imaging,900 Hospital of PLA Joint Service Support Force,Fuzhou,Fujian Province 350025,China)

机构地区：[1]蚌埠医学院第一附属医院放射科,安徽蚌埠233000 [2]蚌埠医学院医学影像学院,安徽蚌埠233000 [3]中国人民解放军联勤保障部队第九〇〇医院医学影像科,福建福州350025

出　　处：《实用放射学杂志》2021年第4期575-578,582,共5页Journal of Practical Radiology

基　　金：蚌埠医学院转化医学重点专项基金资助项目(BYTM2019043).

摘　　要：目的 探讨X线摄影联合导丝定位切除术在乳腺影像报告和数据系统(BI-RADS)4类钙化中的应用价值.方法 选取采用术前钼靶X线引导下导丝定位切除的60例(共61个病灶)可疑钙化(BI-RADS介于4A~4C)病例进行分析.结果 61个病灶中恶性17个,良性44个.X线摄影联合导丝定位切除对BI-RADS 4类钙化诊断的准确度、敏感度、特异度、阳性预测值、阴性预测值分别为80.3%、88.2%、77.3%、60.0%、94.4%,曲线下面积(AUC)为0.83,BI-RADS 4A、4B、4C的恶性率分别为5.6%、47.1%、87.5%.在钙化的密度、分布、形态方面,良、恶性钙化均有统计学差异(P<0.05).结论 X线摄影联合导丝定位切除可以较为准确地发现和定位BI-RADS 4类钙化灶,并协助临床进行精准手术切除,具有简单、准确、微创的特点.Objective To investigate the application value of mammography combined with wire-guided localization and excision in breast imaging reporting and data system(BI-RADS)4 caleification lesions.Methods 60 patients(61 lesions)with suspicious calcification lesions(BI RADS between 4A-4C)under wire localization by mammography guidance and excision were analyzed.Results A mong the 61 lesions,there were 17 malignant lesions and 44 benign lesions.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of mammography combined with wire-guided localization and excision for the diagnosis as BIRADS 4 caleification lesions were 80.3%,88.2%,77.3%,60.0%and 94.4%,respectively.The area under the curve(AUC)was 0.83.The malignant rate of the BI RADS 4A,4B and 4C lesions were 5.6%,47.1%,87.5%,respectively.There were statistical differences in the density,distribution and morphology of the caleifications between benign and malignant lesions(P<0.05).Conclusion Mammography combined with wire-guided localization and excision can accurately find and locate BI RADS 4 caleifications,and assist excising lesion accurately for the clinical surgery.It has the characteristics of simple,accurate,and minimally invasive.

关 键 词：乳腺X线摄影术 导丝定位切除术 钙化 乳腺影像报告和数据系统 

分 类 号：R814.41[医药卫生—影像医学与核医学] R816.4[医药卫生—放射医学]