锥光束乳腺CT、钼靶、超声及MRI对乳腺病变的诊断价值及卫生经济学评价  

The diagnostic value of cone-beam breast CT,mammography,ultrasound and MRI in breast lesions and evaluation of health economics

作　　者：张毓 苏丹柯[1,2,3] 廖海 曾馨逸 康巍[1,2,3] 王中海[4] ZHANG Yu;SU Danke;LIAO Hai;ZENG Xinyi;KANG Wei;WANG Zhonghai(Department of Radiology,Guangri Medical Uhiversity Cancer Hospital,Naming 53000,China;Key Clinical Specialty,Guangxi Medical Uhiversity Cancer Hospital,Naming 530000,China;Dominant Cultization Discipline,Guangri Medical University Cancer Hospital,Naming 530000,China;Guangri Medical University,Nanming 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院放射科,广西南宁530000 [2]广西医科大学附属肿瘤医院临床重点专科,广西南宁530000 [3]广西医科大学附属肿瘤医院优势学科,广西南宁530000 [4]广西医科大学,广西南宁530021

出　　处：《实用放射学杂志》2023年第1期53-56,共4页Journal of Practical Radiology

基　　金：国基自然科学基金项目(81971591,81760517);广西影像医学临床医学研究中心建设项目(桂科AD20238096);广西科技计划项目(桂科AB18221089);广西医科大学特色新型智库调研课题项目(GXMUZK20)。

摘　　要：目的比较锥光束乳腺CT(CBBCT)、钼靶、超声和MRI对乳腺病变的诊断效能和成本效果分析.方法回顾性选取经手术或穿刺病理确诊乳腺疾病的139例患者(143个病灶).均行CBBCT、钼靶、超声和MRI检查.以病理结果为金标准,比较各影像检查的诊断价值并评价成本效果比(CER).结果CBBCT、钼靶、超声及MRI诊断乳腺病变的准确率分别为90.91%、79.02%、82.52%、90.21%,CER分别为13.29、2.53、0.91、12.71.以超声为基准,钼靶、MRI及CBBCT的增量成本效果比(ICER)分别为-35.80、139.38、135.15.结论超声的CER较低,是一种经济且有效的选择;CBBCT对乳腺病变的诊断效能与MRI相当且明显优于钼靶及超声,在乳腺患者经济充足的情况下,选用CBBCT及MRI,患者可获得更好的诊断效果.而CBBCT的ICER低于MRI,因此相比MRI,选择CBBCT作为乳腺疾病患者的诊断方法可在保证诊断效能的同时,有效减低患者的成本.Objective To compare the diagnostic efficacy and cost-effectiveness analyses of cone-beam breast CT(CBBCT),mammography,ultrasound,and MRI in breast lesions.Methods A total of 143 lesions of 139 patients with breast diseases were analyzed retrospectively,and they were confirmed by surgery or puncture pathology.All patients underwent CBBCT,mammography,ultrasound,and MRI examinations.The diagnostic value of various imaging examinations was compared with pathological results as the gold standard,and the cost-effectiveness ratio(CER)was evaluated.Results The accuracy of CBBCT,mammography,ultrasound and MRI in diagnosing breast lesions was 90.91%,79.02%,82.52%,and 90.21%,respectively,and the CER were 13.29,2.53,0.91 and 12.71,respectively.Based on ultrasound,the incremental cost-effectiveness ratio(ICER)of mammography,MRI and CBBCT were-35.80,139.38,and 135.15,respectively.Conclusion Ultrasound is an economical and effective choice with low CER.The diagnostic efficacy of CBBCT in breast lesions is similar to MRI and obviously superior to mammography and ultrasound.Under the condition that breast patients are economically sufficient,CBBCT and MRI can obtain better diagnostic effects.However,the ICER of CBBCT is lower than that of MRI.Therefore,compared with MRI,choosing CBBCT as the diagnostic method for patients with breast diseases can not only ensurethe diagnostic efficiency,but also effectively reduce the cost of patients.

关 键 词：锥光束乳腺CT 钼靶 超声 磁共振成像 乳腺病变 

分 类 号：R814.42[医药卫生—影像医学与核医学] R445.2[医药卫生—放射医学] R655.8[医药卫生—临床医学]