数字乳腺断层摄影诊断乳腺结构扭曲病变的价值  

Imaging Features of Architectural Distortion Detected by Digital Breast Tomography

作　　者：柏玉涵[1] 杨健[2] 蒋玮丽[1] 龙斌[1] 董进[1] 张东友[1] BAI Yuhan;YANG Jian;JIANG Weili;LONG Bin;DONG Jin;ZHANG Dongyou(Department of Radiology,Wuhan No.1 Hospital,Wuhan 430022,China;不详)

机构地区：[1]武汉市第一医院放射科,湖北武汉430022 [2]武汉市第一医院消化内科,湖北武汉430022

出　　处：《中国医学影像学杂志》2022年第1期36-41,共6页Chinese Journal of Medical Imaging

基　　金：武汉市卫生计生委科研计划资助项目(WX20D05)。

摘　　要：目的探讨数字乳腺断层摄影(DBT)对以结构扭曲征象为主要表现的乳腺病变的诊断价值。资料与方法回顾性分析2018年4月—2019年12月于武汉市第一医院经DBT检出乳腺结构扭曲的69例患者的DBT、全数字化乳腺摄影(FFDM)及超声资料,以病理结果为标准,对乳腺良、恶性结构扭曲征象特点(形态学、中心密度、有无局灶性致密)进行比较。结果49例(71.01%)为恶性病变,20例(28.99%)为良性病变。对于DBT检出的69例病灶,FFDM发现其中31例,FFDM检出的良、恶性病变差异无统计学意义(χ^(2)=1.155,P=0.283);超声发现其中48例,超声检出的良、恶性病变差异有统计学意义(χ^(2)=11.627,P<0.01)。48例(97.96%)恶性结构扭曲在DBT中显示为不对称形态,良、恶性病灶形态学差异有统计学意义(χ^(2)=31.202,P<0.01),44例(89.80%)恶性结构扭曲表现为病灶中心高密度,良、恶性病灶中心密度差异有统计学意义(χ^(2)=32.679,P<0.01)。局灶性不对称更常见于恶性结构扭曲,单纯结构扭曲相对倾向良性,差异有统计学意义(χ^(2)=5.231,P<0.05)。形态对称、中心透亮和单纯结构扭曲的阴性预测值分别为92.30%、76.19%和35.85%。不对称形态、中心高密度和局灶性不对称致密相关的恶性结构扭曲的阳性预测值分别为85.71%、91.67%和93.75%。结论DBT显示的三维特征对于良、恶性结构扭曲的鉴别诊断具有重要价值,超声能检出的结构扭曲病灶更倾向于恶性。Purpose To analyze the characteristics of architectural distortion(AD)of benign and malignant breast lesions via digital breast tomography(DBT),and to evaluate the pathological and ultrasound characteristics.Materials and Methods The DBT,full-field digital mammography(FFDM)and ultrasound data of 69 patients in Wuhan No.1 Hospital from April 2018 to December 2019 with AD lesions detected by DBT were retrospectively analyzed.Based on the pathological standard,the characteristics of benign and malignant AD(including morphology,central density,presence or absence of focal denseness,etc.)were compared and analyzed,respectively.Results A total of 49 cases(71.01%)were pathologically confirmed as malignant lesions,20 cases(28.99%)were confirmed as benign lesions.Of the 69 lesions detected by DBT,only 31 lesions were found by FFDM.There was statistically significant difference in FFDM detection between benign and malignant lesions(χ^(2)=1.155,P=0.283).A total of 48 lesions were found by ultrasound,and there was significant difference in ultrasound detection between benign and malignant lesions(χ^(2)=11.627,P<0.01).All 48 cases(97.96%)of malignant AD showed asymmetrical morphology in DBT.There was statistically significant difference in morphology between benign and malignant lesions(χ^(2)=31.202,P<0.01).A total of 44 cases(89.80%)of malignant AD were manifested as central high density.There was statistically significant difference in central density between benign and malignant lesions(χ^(2)=32.679,P<0.01).Focal asymmetry was more common in malignant AD,pure AD was relatively benign,and the difference was statistically significant(χ^(2)=5.231,P<0.05).The negative predictive value of benign AD associated with the symmetrical morphology,the center translucent and pure AD were 92.30%,76.19%and 35.85%,respectively.The positive predictive value of malignant AD associated with asymmetric morphology,central high density and focal asymmetric were 85.71%,91.67%and 93.75%,respectively.Conclusion The three-dimensional features

关 键 词：乳腺疾病 乳房X线摄影术 超声检查 乳房 结构扭曲 数字乳腺断层摄影 病理学 外科 诊断 鉴别 

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]