乳腺断层摄影和超声对不同病理级别非钙化型导管原位癌的诊断效能  

Non-Calcified Ductal Carcinoma in situ of the Breast:Comparison of Diagnostic Value in Different Pathological Grades Between Digital Breast Tomosynthesis and Ultrasonography

作　　者：苏晓慧[1] 李超 林青[1] 崔春晓[1] 边甜甜[1] 李丽丽[1] SU Xiaohui;LI Chao;LIN Qing;CUI Chunxiao;BIAN Tiantian;LI Lili(Department of Breast Imaging,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;不详)

机构地区：[1]青岛大学附属医院乳腺影像科,山东青岛266000 [2]青岛市中心医院结直肠肛门外科,山东青岛266000

出　　处：《中国医学影像学杂志》2022年第11期1130-1135,共6页Chinese Journal of Medical Imaging

基　　金：国家重点研发计划(2016YFC1303004)。

摘　　要：目的比较数字乳腺断层摄影(DBT)、数字乳腺X线摄影(DM)及超声检查(US)对不同病理级别乳腺非钙化型导管原位癌(NCDCIS)的诊断价值。资料与方法回顾性分析青岛大学附属医院2017年3月—2020年12月经手术病理证实的137例NCDCIS的病例资料。以乳腺影像报告和数据系统为诊断标准,比较DBT、DM、US对不同病理级别NCDCIS的诊断价值,以及同一种检查方法对不同病理级别NCDCIS的诊断价值,并与钙化型原位癌进行对比分析。结果US对低中级别NCDCIS的检出率(98.1%,89/90)高于DBT(81.1%,73/90)及DM(71.1%,64/90),差异均有统计学意义(χ^(2)=15.802、27.233,P均<0.001)。US及DBT对高级别NCDCIS的检出率(97.9%,46/47;85.1%,40/47)均高于DM(61.7%,29/47),差异均有统计学意义(χ^(2)=19.064,P<0.001;χ^(2)=6.594,P=0.010)。US及DBT对低中级别NCDCIS的诊断准确率(65.6%,59/90;63.3%,57/90)均高于DM(44.4%,40/90),差异均有统计学意义(χ^(2)=8.103,P=0.004;χ^(2)=6.461,P=0.011)。US(70.2%,33/47)及DBT(66.0%,31/47)对高级别NCDCIS的诊断准确率均高于DM(27.7%,13/47),差异均有统计学意义(χ^(2)=17.029、13.844,P均<0.001)。钙化型原位癌中,低中级别及高级别病变分别为37.7%(114/302)、62.3%(188/302);NCDCIS中,低中级别及高级别病变分别为65.7%(90/137)、34.3%(47/137),差异有统计学意义(χ^(2)=29.587,P<0.001)。结论US对乳腺NCDCIS的检出率及诊断准确性均具有明显优势,与病理级别无关。同一种检查方法对不同病理级别NCDCIS的诊断价值无明显差异。高级别DCIS病变以钙化型居多,低中级别DCIS病变以非钙化型居多。Purpose To compare the diagnostic value of digital breast tomosynthesis(DBT),digital mammography(DM)and ultrasonography(US)in different pathological grades of non-calcified ductal carcinoma in situ(NCDCIS)of the breast.Materials and Methods 137 cases of NCDCIS of the breast who were confirmed by surgery and pathology from March 2017 to December 2020 in the Affiliated Hospital of Qingdao University were included in the study.The radiologic findings were evaluated according to the breast imaging reporting and data system,comparing differences in the diagnostic value between the three techniques for the different pathological grades of NCDCIS and the differences in the diagnostic value of the same technique for the different pathological grades of NCDCIS,and compared with calcified DCIS.Results The detection rate of US(98.1%,89/90)for low-and mid-grade NCDCIS was greater than DBT(81.1%,73/90)or DM(71.1%,64/90),and the difference was statistically significant(χ^(2)=15.802,27.233,P<0.001).The detection rates of US(97.9%,46/47)and DBT(85.1%,40/47)for high-grade NCDCIS was greater than DM(61.7%,29/47),the difference was statistically significant(χ^(2)=19.064,P<0.001;χ^(2)=6.594,P=0.010).The diagnostic accuracy of US(65.6%,59/90)and DBT(63.3%,57/90)for low-and mid-grade NCDCIS was greater than that of DM(44.4%,40/90),and the difference was statistically significant(χ^(2)=8.103,P=0.004;χ^(2)=6.461,P=0.011).The diagnostic accuracy of US(70.2%,33/47)and DBT(66.0%,31/47)for high-grade NCDCIS was greater than that of DM(27.7%,13/47),and the difference was statistically significant(χ^(2)=17.029,13.844,P<0.001).The low-and mid-grade lesions and high-grade lesions in calcified DCIS were 37.7%(114/302)and 62.3%(188/302),those in NCDCIS were 65.7%(90/137)and 34.3%(47/137),the difference was statistically significant(χ^(2)=29.587,P<0.001).Conclusion US has obvious advantages in detection and diagnosis of NCDCIS and are unrelated to the pathological grade.There was no significant difference in the diagnostic value of the same

关 键 词：乳腺肿瘤 癌 原位 超声检查 乳房X线摄影术 病理学 外科 诊断 

分 类 号：R730.4[医药卫生—肿瘤] R737.9[医药卫生—临床医学]