数字乳腺断层重建2D图像技术在乳腺病变诊断中的应用价值  

Application Value of 2D Image Reconstruction Technique by Digital Breast Tomosynthesis in Diagnosis of Breast Lesions

作　　者：梁旭[1] 姚建莉[1] 董晓蕾[1] 徐忠孜 许国辉[1] 周鹏[1] LIANG Xu;YAO Jianli;DONG Xiaolei;XU Zhongzi;XU Guohui;ZHOU Peng(Department of Radiology,Sichuan Cancer Hospital,Chengdu Sichuan 610041,China)

机构地区：[1]四川省肿瘤医院影像科,四川成都610041

出　　处：《中国医疗设备》2023年第2期68-72,共5页China Medical Devices

基　　金：国家科技部重点研发项目(2017YFC0109405)。

摘　　要：目的通过与全视野数字化乳腺X线摄影(Full Field Digital Mammography,FFDM)对比,探讨数字乳腺断层重建的合成二维图像(Synthetic Mammography,SM)在诊断乳腺良恶性病变中的应用价值。方法回顾性分析我院153例乳腺良、恶性病变患者的FFDM与SM图像,比较2组图像病变可见性评级、影像征象、BI-RADS分类及平均腺体剂量,以病理结果为“金标准”,ROC曲线评估2组图像诊断效能。结果FFDM与SM病变可见性评级存在统计学差异,SM病变显示略优于FFDM(Z=-3.130,P=0.002);2组图像显示乳腺病变影像征象一致性较好,Kappa值为0.827~0.900;FFDM与SM诊断乳腺良恶性病变的曲线下面积分别为0.847(95CI%:0.774~0.921)和0.861(95CI%:0.789~0.933),差异无统计学意义(Z=-1.347,P=0.178);FFDM与SM的平均腺体剂量差异有统计学意义(P<0.001),SM+DBT平均腺体剂量相比FDM+DBT降低约45%(3.29/6.01)。结论SM与FFDM在乳腺良恶性病变诊断中的应用价值相当,SM可替代FFDM作为二维图像与DBT联合应用于乳腺病变检查,且没有增加辐射剂量。Objective To explore the application value of 2D image synthetic mammography(SM)reconstructed digital breast tomosynthesis compared with full field digital mammography(FFDM)in the diagnosis of benign and malignant breast lesions.Methods The FFDM and SM images of 153 cases of benign and malignant breast lesions in our hospital were retrospectively analyzed.The visibility rating,imaging signs,BI-RADS classification and average gland dose of the two groups were compared.ROC curves were used to evaluate the diagnostic efficacy of the two images according to pathologic results.Results There was statistical difference between FFDM and SM in the visibility rating of lesions.SM showed lesions slightly better than FFDM(Z=-3.130,P=0.002).The image signs of breast lesions in the two groups showed good consistency with Kappa value of 0.827-0.900.The areas under the curve of FFDM and SM in the diagnosis of benign and malignant breast lesions were 0.847(95CI%:0.774-0.921)and 0.861(95CI%:0.789-0.933),respectively,with no significant difference(Z=-1.347,P=0.178).The average gland dose of FFDM and SM was significantly difference(P<0.001),and the average gland dose of SM+DBT was about 45%lower than that of FDM+DBT(3.29/6.01).Conclusion Diagnostic performances of SM and FFDM images were comparable for detecting breast cancers.SM can be used as an alternative to FFDM as a two-dimensional image in combination with DBT in the examination of breast lesions,without increasing radiation dose.

关 键 词：数字乳腺断层 合成二维图像 全视野数字化乳腺X线摄影 乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]