全数字化乳腺钼靶摄影对男性乳腺病变良恶性的鉴别诊断  

Value of the full-field digital mammography in the differential diagnosis of benign and malignant male breast lesion

作　　者：汤晓敏[1] 段惠予 李淑华[1] 朱芸[1] 陈路 谢宗玉[1] TANG Xiao-min;DUAN Hui-yu;LI Shu-hua;ZHU Yun;CHEN Lu;XIE Zong-yu(Department of Radiology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004;Graduate School,Bengbu Medical College,Bengbu Anhui 233030,China)

机构地区：[1]蚌埠医学院第一附属医院放射科,安徽蚌埠233004 [2]蚌埠医学院研究生院,安徽蚌埠233030

出　　处：《蚌埠医学院学报》2022年第8期1083-1087,共5页Journal of Bengbu Medical College

基　　金：蚌埠医学院自然科学重点项目(2020byzd176)。

摘　　要：目的:探讨全数字化乳腺钼靶摄影(full-field digital mammography,FFDM)对男性乳腺病变良恶性的鉴别诊断价值。方法:收集2018年7月至2021年10月经FFDM检查并取得病理结果的21例男性乳腺肿块病人及65例女性乳腺癌病人资料。回顾性分析其临床及影像学特征并进行比较,采用受试者工作特征性(ROC)曲线下面积(AUC)来评估FFDM对男性乳腺病变的诊断效能。结果:21例男性乳腺病变中良性13例,恶性8例。男性乳腺恶性病变组肿块以及有无周围血管增粗(或增多)发生率均高于良性病变组,局灶不对称影发生率低于良性病变组,差异均有统计学意义(P<0.05);2组结构扭曲、乳头凹陷发生率比较,差异均无统计学意义(P>0.05)。男性乳腺癌组乳头凹陷发生率高于女性乳腺癌组,可疑恶性钙化发生率低于女性乳腺癌组,差异均有统计学意义(P<0.05);2组肿块、局灶不对称影、周围血管增粗(或增多)、结构扭曲、肿块边缘模糊和肿块毛刺征发生率比较,差异均无统计学意义(P>0.05)。FFDM对于男性乳腺疾病诊断的AUC为0.885,敏感度100%,特异度76.9%,符合率85.7%,阳性预测值72.7%,阴性预测值100%。结论:FFDM对男性乳腺良恶性病变具有较好地诊断价值,肿块及周围血管增粗(或增多)是诊断男性乳腺癌最重要的影像表现,良性病变以男性乳腺发育最常见,多表现为局灶不对称影。Objective:To evaluate the value of full-field digital mammography(FFDM) in the differential diagnosis of benign and malignant male breast lesions.Methods:Twenty-one male patients with breast mass and 65 female breast cancer patients detected by FFDM and pathology from July 2018 to October 2021 were investigated.The clinical and radiographic features of all cases were retrospectively analyzed.The area under the receiver operating characteristic curve(AUC) was used to evaluate the differential diagnosis efficacy of FFDM for benign and malignant breast lesions.Results:Among the 21 cases,13 cases were benign,and 8 cases were malignant.The incidence rates of mass and peripheral vascular thickening(or increase) in the male breast malignant lesions groups were higher than those in the benign lesions group,and the incidence rate of focal asymmetric shadow of which was lower than that in the benign lesions group(P0.05).The incidence rate of nipple depression in male breast cancer group was higher than that in female breast cancer group,and the incidence rate of suspected malignant calcification of which was lower than that in female breast cancer group(P0.05).The AUC of FFDM for the diagnosis of male breast disease was 0.885,and the sensitivity,specificity,incidence rate,positive predictive value and negative predictive value were 100%,76.9%,85.7%,72.7% and 100%,respectively.Conclusions:FFDM has a good diagnostic value for benign and malignant male breast lesions.The mass and thickening(or increase) of peripheral blood vessels are the most important imaging findings in the diagnosis of male breast cancer.Male mammary gland development was the most common benign lesion,and the benign lesions are mostly manifested as focal asymmetric shadows.

关 键 词：全数字化乳腺钼靶摄影 乳腺病变 男性 鉴别诊断 

分 类 号：R445.4[医药卫生—影像医学与核医学]