乳腺三维断层技术结合乳腺超声对致密型乳腺病变的诊断价值  

Diagnostic Value of Digital Breast Tomosynthesis Combined with Breast Ultrasonography in Dense Breast Lesions

作　　者：蒋尧西 彭松 牟灿[1] 杨巧丽 田伟 JIANG Yao-xi;PENG Song;MU Can;YANG Qiao-li;TIAN Wei(Department of Radiology,Chongqing Health Center for Women and Children,Chongqing,401147,China)

机构地区：[1]重庆市妇幼保健院放射科,重庆401147

出　　处：《现代生物医学进展》2021年第20期3988-3992,3931,共6页Progress in Modern Biomedicine

基　　金：重庆市技术创新与应用示范(社会民生类)一般项目(cstc2018jscx-msybX0085)。

摘　　要：目的:探讨乳腺三维断层技术(DBT)结合乳腺超声(BUS)对致密型乳腺病变的诊断价值。方法:回顾分析2018年6月至2019年4月在我院就诊且有完整病理结果的149例致密型乳腺病变患者的影像资料,对比DBT、BUS两种检查方法的检出率;以病理结果为金标准,分析DBT、BUS、DBT联合BUS三种检查模式的诊断效能。结果:BUS对良性病变的检出率(97.87%)高于DBT(89.36%),差异有统计学意义(x^(2)=5.697,P<0.05);DBT与BUS对恶性病变的检出率分别为98.44%、95.31%,差异无统计学意义(x^(2)=1.032,P>0.05)。DBT诊断致密型乳腺病变的敏感度为90.61%、特异度为93.55%、准确率为91.77%,BUS诊断致密型乳腺病变的敏感度为78.13%、特异度为89.36%、准确率为84.81%,DBT联合BUS诊断致密型乳腺病变的敏感度为95.31%、特异度为95.74%、准确率为95.57%。DBT联合BUS诊断致密型乳腺恶性病变的受试者工作特征曲线(ROC)的曲线下面积(AUC)为0.977,稍高于DBT的AUC(0.951),明显高于BUS的AUC(0.885)。结论:BUS对良性病变的检出率显著高于DBT,DBT对致密型乳腺病变的诊断效能高于BUS,二者结合能提高病变的检出率与诊断效能。Objective:To investigate the diagnostic value of digital breast tomosynthesis(DBT)combined with breast ultrasonography(BUS)in dense breast lesions.Methods:The imaging data of 149 patients with dense breast lesions with complete pathological findings who were admitted to our hospital from June 2018 to April 2019 were retrospectively analyzed,and the detection rates of DBT and BUS of two inspection methods were compared.The pathological results were taken as the gold standard,the diagnostic efficiency of DBT,BUS and DBT combined BUS were analyzed.Results:The detection rate of BUS in benign lesions(97.87%)was higher than DBT(89.36%),the difference was statistically significant(x^(2)=5.697,P<0.05).The detection rates of DBT and BUS for malignant lesions were 98.44%and 95.31%,respectively,and the differences were not statistically significant(x^(2)=1.032,P>0.05).The sensitivity of DBT in diagnosis of dense breast lesions was 90.61%,the specificity was 93.55%,the accuracy rate was 91.77%.The sensitivity of BUS in diagnosis of dense breast lesions was 78.13%,the specificity was 89.36%,the accuracy rate was 84.81%.The sensitivity of DBT combined with BUS in diagnosis of dense breast lesions was 95.31%,the specificity was 95.74%,the accuracy rate was 95.57%.The area under the receiver operating characteristic curve(ROC)of DBT combined with BUS for diagnosis of dense breast lesions was 0.977,which was slightly higher than that of DBT(0.951),and significantly higher than that of BUS(0.885).Conclusion:The detection rate of BUS for benign lesions is significantly higher than that of DBT,and the diagnosis efficiency of DBT for dense breast lesions is higher than that of BUS,the combined application of the two methods can improve the detection rate and diagnostic efficiency of lesions.

关 键 词：数字乳腺三维断层技术 乳腺超声 乳腺病变 诊断 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]