数字乳腺摄影联合超声在小乳腺癌诊断中的应用  

Application of Digital Mammography Combined with Ultrasound in Diagnosis of Small Breast Cancer

作　　者：胡丹婷 郑晓静 尤超 黄云霞 沈茜刚 顾雅佳 Hu Danting;Zheng Xiaojing;You Chao;Huang Yunxia;Shen Xigang;Gu Yajia(Fudan University Shanghai Cancer Center,Shanghai 200032,China;Shanghai Medical College,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属肿瘤医院超声诊断科,上海市200032 [2]复旦大学上海医学院肿瘤学系,上海市200032

出　　处：《中国超声医学杂志》2022年第3期267-270,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨两种数字乳腺摄影联合超声检查在小乳腺癌诊断中的应用价值。方法选取乳腺癌疑似病例共260例作为研究对象,所有病例均接受数字乳腺断层摄影(DBT)、全数字化乳腺摄影(FFDM)和超声检查。回顾性分析DBT+FFDM、超声单用与联用对小乳腺癌的诊断效能。结果超声共诊断出乳腺癌198例,DBT+FFDM诊断出196例,两项联合诊断出226例。3种检查方法中两项联合的AUC值最大(0.898),两项联合与超声、DBT+FFDM的AUC值对比,差异均有统计学意义(Z=4.024、3.108,P=0.001、0.002),超声与DBT+FFDM的AUC值对比差异无统计学意义(Z=0.859,P=0.391)。相比超声和DBT+FFDM单用,两项联合的诊断灵敏度及诊断效能最高。不论是直径≤1.0 cm还是直径在1.0~3.0 cm的乳腺癌,两项联合的诊断灵敏度均优于单一检查(P<0.05)。结论超声、DBT联合FFDM对小乳腺癌均有较高的诊断价值,二者联用能够提高小乳腺癌的诊断灵敏度与准确度,临床可联合应用超声、DBT和FFDM以降低乳腺癌的漏诊风险。Objective To explore the value of two kinds of digital mammography combined with ultrasonography in the diagnosis of small breast cancer.Methods A total of 260 suspected cases of breast cancer in our hospital were selected as the research objects.All cases were examined by digital breast tomography(DBT),full field digital mammography(FFDM)and frequency ultrasound.The diagnostic efficacy of DBT+FFDM and ultrasound alone or in combination for early breast cancer was retrospectively analyzed.Results A total of 198 cases of breast cancer were diagnosed by ultrasound,196 cases were diagnosed by DBT+FFDM,and 226 cases were diagnosed by combination of the two methods.Among the three examination methods,the AUC value of the two combinations was the highest(0.898).The difference between and the AUC values of the two combinations were statistically significant compared with those of ultrasound and DBT+FFDM(Z=4.024,3.108,P=0.001,0.002).There was no significant difference in AUC value between ultrasound and DBT+FFDM(Z=0.859,P=0.391).Compared with ultrasound and DBT+FFDM alone,the combination of the two methods had the highest diagnostic sensitivity and diagnostic efficiency.Both breast cancer with diameter≤1.0 cm or diameter 1.0~3.0 cm,the two combined diagnostic sensitivity was better than that of the single test(P<0.05).Conclusions Ultrasound,DBT combined with FFDM have high diagnostic value for small breast cancer.The combination of the two methods can improve the sensitivity and accuracy of small breast cancer diagnosis.In clinic,ultrasound,DBT and FFDM can be combined to reduce the risk of missed diagnosis of breast cancer.

关 键 词：乳腺癌 超声 数字乳腺三维断层摄影 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]