数字乳腺断层X线摄影与超声光散射断层成像诊断早期乳腺癌的对比研究  

Digital Breast Tomosynthesis and Optical Tomography Image Ultrasongraphy in the Diagnosis of Early Breast Cancer:A Comparative Study

作　　者：刘颖[1] 董苑[1] 陈诚[1] LIU Ying;DONG Yuan;CHEN Cheng(Department of Breast Surgery,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院乳腺外科,云南昆明650032

出　　处：《中国医学影像学杂志》2022年第6期570-574,共5页Chinese Journal of Medical Imaging

摘　　要：目的比较数字乳腺断层X线摄影(DBT)与超声光散射断层成像(OPTIMUS)对早期乳腺癌的诊断价值。资料与方法回顾性收集2019年2月—2020年6月于昆明医科大学第一附属医院同时接受DBT和OPTIMUS检查的158例乳腺癌患者共158个病灶,根据病灶形态分为肿块型及非肿块型,根据病灶大小分为直径≤1 cm及直径>1 cm。以乳腺影像报告和数据系统分类作为诊断依据,以病理结果作为“金标准”,绘制受试者工作特征曲线,比较DBT和OPTIMUS对早期乳腺癌的诊断效能、漏诊率及误诊率。结果DBT和OPTIMUS诊断早期乳腺癌的曲线下面积分别为0.805和0.972,差异有统计学意义(Z=3.985,P<0.001)。在肿块型病灶、非肿块型病灶及直径≤1 cm病灶分组中,DBT和OPTIMUS诊断早期乳腺癌的曲线下面积差异均有统计学意义(Z=2.250、2.315、3.835,P<0.05)。DBT和OPTIMUS诊断早期乳腺癌的特异度分别为33.33%(4/12)和75.00%(9/12),误诊率分别为66.67%(8/12)和25.00%(3/12),差异有统计学意义(P=0.007);DBT和OPTIMUS诊断早期乳腺癌的敏感度分别为90.41%(132/146)和95.89%(140/146),漏诊率分别为9.59%(14/146)和4.10%(6/146),差异无统计学意义(P>0.05)。结论OPTIMUS诊断早期乳腺癌的整体效能优于DBT,尤其适合诊断直径≤1 cm的病灶;DBT对非肿块型早期乳腺癌的诊断效能优于OPTIMUS,更适合检出非对称结构、结构扭曲等病灶;临床诊断乳腺癌时,对于触诊阴性病灶更适合采用OPTIMUS,对于不对称增厚病灶更合采用DBT。Purpose To compare the diagnostic value of digital breast tomosynthesis(DBT)and optical tomography image ultrasonography system(OPTIMUS)in early breast cancer.Materials and Methods A total of 158 patients(158 breast lesions)underwent DBT and OPTIMUS in the First Affiliated Hospital of Kunming Medical University from February 2019 to June 2020.All lesions were divided into mass lesion and non-mass lesion according to lesion form,also divided into lesions with diameter≤1 cm and diameter>1 cm according to lesion size.Taking breast imaging report and data system classification as the diagnostic basis and pathological results as gold standards,receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performances of DBT and OPTIMUS,the misdiagnosis rate and false positive rate of them were compared.Results The area under curve(AUC)of DBT and OPTIMUS in diagnosing early breast cancer was 0.805 and 0.972,respectively(Z=3.985,P<0.001).There were significant differences in AUC between DBT and OPTIMUS in mass lesion,non-mass lesion and lesions with diameter≤1 cm in the diagnosis of early breast cancer(Z=2.250,2.315,3.835,P<0.05).The specificity of DBT and OPTIMUS in diagnosing early breast cancer was 33.33%(4/12)and 75.00%(9/12),respectively;and the false positive rate was 66.67%(8/12)and 25.00%(3/12),respectively,with statistical significance(P=0.007);the sensitivity of DBT and OPTIMUS in diagnosing early breast cancer was 90.41%(132/146)and 95.89%(140/146),respectively;and the misdiagnosis rate was 9.59%(14/146)and 4.10%(6/146),respectively,with no statistical significance(P>0.05).Conclusion OPTIMUS shows better diagnostic performance than DBT in the diagnosis of early breast cancer,and it is especially suitable for the diagnosis of lesions with diameter≤1 cm.DBT is better than OPTIMUS in the diagnosis of non-mass early breast cancer,and DBT is more suitable for the detection of asymmetrical structure and structural distortion lesions.In clinical diagnosis of breast cancer,OPTIMUS is more suit

关 键 词：乳腺肿瘤 乳房X线摄影术 超声检查 光散射断层成像系统 病理学 外科 诊断 鉴别 

分 类 号：R737.9[医药卫生—肿瘤] R730.42[医药卫生—临床医学]