对比增强能谱X线摄影对致密型乳腺病变的诊断价值  

Diagnostic Performance of Contrast-Enhanced Spectral Mammography in Breast Lesions of Dense Breasts

作　　者：荣小翠[1] 康一鹤 杨光[1] 韩捧银[1] 薛晶 李亚男[1] 李智岗[1] RONG Xiaocui;KANG Yihe;YANG Guang(Department of Radiology,the Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei Province 050011,P.R.China)

机构地区：[1]河北医科大学第四医院放射科,石家庄050011

出　　处：《临床放射学杂志》2021年第6期1092-1096,共5页Journal of Clinical Radiology

摘　　要：目的通过与数字乳腺断层摄影(DBT)对比,探讨对比增强能谱乳腺X线摄影(CESM)对于致密型乳腺病变的诊断价值。方法回顾性分析行CESM检查经穿刺活检或手术病理证实的115例致密型乳腺疾病患者,与病理结果对照,比较DBT、CESM对于乳腺疾病的诊断效能。结果115例患者共检出125个病灶,其中乳腺癌病灶70个,良性病灶55个。以BI-RADS 4B类及以上为阳性时,DBT、CESM两者诊断的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为81.4%、54.5%、69.6%、69.5%、69.8%和94.3%、72.7%、84.8%、81.5%、90.9%。受试者工作特征(ROC)曲线下面积分别为0.716、0.877,差异有统计学意义(P<0.05)。在未绝经组和年龄≤50岁组中,CESM诊断乳腺病变的ROC曲线下面积大于DBT(P<0.05);而在已绝经和年龄>50岁组中,DBT和CESM诊断乳腺病变的差异无统计学意义(P>0.05)。结论与DBT相比,在未绝经和年龄≤50岁患者中,CESM诊断致密型乳腺病变更具优势。Objective To assess the diagnostic performance of contrast enhanced spectral mammography(CESM)in breast lesions of dense breasts.Methods To retrospectively analyze the clinical and imaging data of 115 female patients with breast lesions which were confirmed by pathology.All cases classified as dense breasts by digital breast tomosynthesis(DBT).Pathological results were taken to compare the diagnostic value of DBT and CESM.Results 125 lesions were found in 115 patients,in which 70 were malignant and 55 were benign.The sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)in the diagnosis of breastlesions were 81.4%,54.5%,69.6%,69.5%and 69.8%for DBT,while they were 94.3%,72.7%,84.8%,81.5%and 90.9%for CESM.The areas under ROC curve(AUC)of DBT and CESM were 0.716,and 0.877,respectively.There was significant difference of AUC(P<0.05).In the group with age≤50 and non-menopausegroup,the areas under ROC curves for CESM was significantly larger than that for DBT(P<0.05).NO significant differences were observed in the group with age>50 and menopause group(P>0.05).Conclusion Compared with DBT,CESM shows a higher diagnostic efficiency in patients with age≤50 and non-menopause.

关 键 词：乳腺病变 对比增强能谱乳腺X线摄影 致密型乳腺 

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