数字乳腺断层X线成像、超声检查在不同类型腺体乳腺内病变诊断价值的对比研究  

A comparative study on the diagnostic value of digital breast tomosynthesis and ultrasonography in breast lesions of different glandular types

作　　者：张冬雪 张晓英 丁莹莹[1] 李卓琳[1] ZHANG Dongxue;ZHANG Xiaoying;DING Yingying;LI Zhuolin(Department of Radiology,Yunan Cancer Hospital,Kunming 650118,China)

机构地区：[1]云南省肿瘤医院放射科,云南昆明650118

出　　处：《实用放射学杂志》2022年第6期919-922,共4页Journal of Practical Radiology

基　　金：云南省卫生健康委员会医学后备人才培养计划项目(H-2018005)。

摘　　要：目的评价数字乳腺断层X线成像(DBT)、超声(US)检查及两者联合应用在女性少量、多量腺体中病变的定性诊断价值.方法回顾性选取201例女性乳腺疾病患者,所有患者均行DBT和US检查.根据美国放射学会(ACR)乳腺影像报告和数据系统(BI-RADS)2013版将本研究中散在纤维腺体和脂肪型统归为少量腺体型,将不均匀致密型和极度致密型腺体统归为多量腺体型,以手术病理检查结果作为金标准,比较2种检查方法在不同腺体分型中单独及联合诊断的效能.结果201例患者共检出202个病灶,其中病理诊断良性64例、恶性138例;少量腺体67例(脂肪型乳腺17例,散在纤维腺体型乳腺50例)、多量腺体134例(不均匀致密型乳腺105例,极度致密型乳腺29例).绝经前患者乳腺腺体分型以多量腺体为主,绝经后以少量腺体为主.DBT、US检查在不同腺体的检查准确率差异不明显(P>0.05).少量腺体患者DBT+US检查与两者单独检查相比准确率差异不明显(χ^(2)=1.77,P>0.05),多量腺体患者DBT+US检查与两者单独检查准确率相比差异有统计学意义(χ^(2)=16.50,P<0.05).结论DBT、US检查对乳腺疾病的诊断效能相当.DBT+US检查较单独两者检查在少量腺体、绝经后的患者中诊断效能相近.对于多量腺体、绝经前的患者,DBT+US检查较两者单独检查能够提高乳腺疾病的诊断效能.Objective To evaluate the diagnostic value of digital breast tomosynthesis(DBT),ultrasonography(US)and their com bination in the diagnosing lesions in female non dense glands and dense glands.Methods A total of 201 female breast disease patients were retrospectively selected,and all patients underwent DBT and US examinations.According to American College of Radiology(ACR)breast imaging reporting and data system(BI RADS)2013,scattered fibrous glands and fatty glands in this study were classified as nonr dense glands,and uneven dense glands and extremely dense glands were clasified as dense glands.Finally,the pathological examination results were used as the gold standard to compare the diagnostic efficacy of the two examination methods and their combination in different gland types respectively.Results 202 lesions were detected in 201 patients,including 64 benign lesions and 138 malignant lesions.There were 67 non-dense glands(17 fatty glands,50 scattered fibrous glands)and 134 dense glands(105 uneven dense glands,29 extremely dense glands).The main types of breast glands in premenopausal patients were dense glands,and in postmenopausal patients were non-dense glands.There was no significant difference in accuracy between DBT and US in different kinds of glands(P>0.05).For patients with non dense glands,there was no significant difference in accuracy between DBT+US and the two tests alone(χ^(2)=1.77,P>0.05).For patients with dense glands,there was a statistically significant difference in accuracy between DBT+US and the two tests alone(χ^(2)=16.50,P<0.05).Conclusion DBT and US have similar diagnostic efficacy in breast diseases.For non dense glands and postmenopausal patients,the diagnostic efficacy of DBT+US is similar to that of single examination.For dense glands and premenopause patients,DBT+US can improve the diagnostic efficacy of breast diseases compared with single examination.

关 键 词：乳腺疾病 数字乳腺断层X线成像 超声 

分 类 号：R655.8[医药卫生—外科学] R814.41[医药卫生—临床医学] R445.1