锥光束乳腺CT与彩超、钼靶、核磁共振单独或联合检查的诊断效能  

Diagnostic Efficacy of CBBCT Separately or When Combined with Ultrasound,Mammography,MRI

作　　者：马爱敏 于滢华[2] 康巍[3] 苏丹柯[3] 莫钦国[2] MA Ai-min;YU Ying-hua;KANG Wei;SU Dan-ke;MO Qin-guo(Department of Breast Surgery,Wuming Hospital Of Guangxi Medical University,NanNing 530100,GuangXi,China;Department of Breast Surgery,Affiliated Cancer Hospital of Guangxi Medical University,NanNing 530000,GuangXi,China;Department of Imaging Center,Affiliated Cancer Hospital of Guangxi Medical University,NanNing 530000,GuangXi,China)

机构地区：[1]广西医科大学附属武鸣医院乳腺外科,广西南宁530100 [2]广西医科大学附属肿瘤医院乳腺外科,广西南宁530000 [3]广西医科大学附属肿瘤医院影像中心,广西南宁530000

出　　处：《中国CT和MRI杂志》2023年第1期101-105,共5页Chinese Journal of CT and MRI

基　　金：广西自然科学基金项目(2020GXNSFBA297072);广西医疗卫生适宜技术开发与推广应用项目(S2021023);广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20220764,Z-A20220734,Z-A20220738)。

摘　　要：目的 对比锥光束乳腺CT与彩超、钼靶、核磁共振单独或联合检查的诊断效能。方法 收集89例广西医科大学附属肿瘤医院2019年7月至2020年1月间临床首诊为乳房肿块的女性患者,全部进行了锥光束乳腺CT、彩超、钼靶、核磁共振检查。按照个体检查和联合检查,共分为15个组别。以病理结果为“金标准”,根据美国放射学学会第5版BI-RADS分类,最后将BI-RADS结果分为阴性(≤3)和阳性(≥4),并采用统计学软件Medcalc 19和SPSS 24对各组的诊断效能进行对比分析。结果 收集到98个病变,其中14个为良性病变,84个为恶性病变。包括锥光束乳腺CT、彩超、钼靶、核磁共振个体和合并的检查共15组,其中锥光束乳腺CT的AUC绝对数为0.78,在所有分组中为最高。联合检查组中e(锥光束乳腺CT+彩超)、g(锥光束乳腺CT+核磁共振)及l(锥光束乳腺CT+彩超+核磁共振)的AUC为0.82,绝对数最高,锥光束乳腺CT分别与各组检查的AUC值比较,P值>0.05,无显著差异。15组检查的Kappa系数,P值均<0.05,差异显著,其中锥光束乳腺CT为0.657。结论 1.锥光束乳腺CT分别与彩超、钼靶、核磁共振比较,其对乳腺病变具有更高的诊断准确率,值得在临床上推广;2.联合检查组比较中,锥光束乳腺CT+彩超、锥光束乳腺CT+核磁共振、锥光束乳腺CT+彩超+核磁共振三个联合检查组的诊断准确性(AUC)一致,三者均优于其它联合检查组,但综合考虑耗时、经济、便利性、造影药品的副作用等因素,锥光束乳腺CT+彩超这个联合检查组具有更高的临床应用价值。Objective To compare the diagnostic efficacy of CBBCT alone or when combined with ultrasound(US), mammography(MG) and MRI. Methods A total of 89 female patients with breast mass diagnosed for the first time in the Guangxi Medical University Cancer Hospital from July 2019 to January 2020 were collected. All of them underwent CBBCT, US, MG and MRI examinations. It was divided into 15 groups according to individual examination and combined examination. With pathological results as the gold standard, according to the classification of BI-RADS in the 5th edition of the American College of Radiology, the results of BI-RADS were finally divided into negative(≤3) and positive(≥4), and statistical software Medcalc 19 and SPSS 24 were used to compare the diagnostic efficacy of each group. Results 98 lesions were collected, of which 14 were benign and 84 were malignant. There were 15 groups including CBBCT, MG, US, MRI individual and combined examination groups. The absolute AUC of CBBCT was 0.78, which was the highest among all groups. In the combined examination group, the AUC values of e(CBBCT+US), g(CBBCT+ MRI) and l(CBBCT+ US+ MRI) were 0.82, with the highest absolute number. The AUC values of CBBCT were respectively compared with those of each group, and there was no significant difference(P>0.05). The differences of Kappa coefficient in 15 groups were statistically significant(P<0.05), of which CBBCT was 0.657. Conclusions 1. Compared with US, MG and MRI, CBBCT has a higher diagnostic accuracy for breast lesions, and CBBCT is worthy of clinical application.2.In the comparative analysis of combined examination group, the diagnostic accuracy(AUC) of CBBCT + US, CBBCT + MRI and CBBCT+US +MRI was consistent, and all of them were superior to other combined examination groups. But considering the factors of time-consuming, economy, side effects of angiographic drugs comprehensively, CBBCT+US combined examination group has higher clinical application value.

关 键 词：锥光束乳腺CT 彩超 钼靶 核磁共振 联合检查 诊断效能 

分 类 号：R604[医药卫生—外科学] R737.9[医药卫生—临床医学] R445.1R445.2R445.3R445.4