单体位联合双体位DBT与FFDM对乳腺癌的诊断价值  

Efficacy of Mono-DBT combined with FFDM in the diagnosis of breast cancer

作　　者：潘婷 邓雪英 范林音[1] 张诗晗 李雅怡 邵国良[2] PAN Ting;DENG Xueying;FAN Linyin;ZHANG Shihan;LI Yayi;SHAO Guoliang(Department of Radiology,Zhejiang Cancer Hospital,Hangzhou 310002,China;Department of Interventional Radiology,Zhejiang Cancer Hospital,Hangzhou 310002,China)

机构地区：[1]浙江省肿瘤医院放射科,浙江杭州310002 [2]浙江省肿瘤医院介入科,浙江杭州310002

出　　处：《医学影像学杂志》2024年第4期53-57,共5页Journal of Medical Imaging

基　　金：浙江省卫生健康面上项目(编号:2021KY091);浙江省医药卫生科研项目(编号:2021KY085)。

摘　　要：目的 探讨单体位[头尾位(craniocaudal, CC)或内外侧斜位(mediolateral oblique, MLO)]数字化乳腺断层合成技术(digital breast tomosynthesis,DBT)联合全视野数字化乳腺X线摄影(full-fild digital mammography,FFDM)检查对乳腺癌的检出率和诊断效能。方法 选取141例乳腺病变患者影像学资料,患者同时行乳腺DBT和FFDM检查。由2位放射科诊断医师分别对患者DBT图像进行单体位和双体位(CC+MLO)阅片并联合FFDM,以病理结果为金标准。分析单体位和双体位DBT检查联合FFDM检查对患者乳腺良恶性病灶的检出率及诊断效能。结果 141例患者按照ACR2013版BI-RADS系统分类标准:a类3例、b类40例、c类84例、d类14例。根据BI-RADS评级标准,2位放射科诊断医师采用四种诊断方式(DBT-CC,DBT-MLO及双体位DBT分别联合FFDM及单独FFDM)进行诊断。结论 采用DBT+FFDM的阅片方式无论是单体位还是双体位的结果假阳性率及假阴性率均低于FFDM,诊断的准确度、特异度及灵敏度均高于FFDM,对高/低年资诊断医师FFDM+DBT双体位的诊断效能高于单体位,在FFDM+DBT-CC和FFDM+DBT-MLO单体位之间准确度、灵敏度和特异度MLO均高于CC位。Objective To investigate the detection rate and diagnostic efficacy of digital breast tomography(DBT)in the monomeric position(Craniocaudal,CC or medial oblique Mediterranean Oblique,MLO)and full-field digital mammography(FFDM).Methods 141 breast cancer patients underwent breast DBT and FFDM examinations at the same time were included in this work.Two breast imaging diagnostic physicians performed monomeric and two-position readings of the patient's DBT images and combined with FFDM. The pathological results were used as the gold standard for control. The detection rate and diag-nostic efficacy of monomer and bi-body DBT combined with FFDM on benign and malignant lesions of the breast were analyzed. Results 141 patients were selected according to the ACR's version of 2013 the BI-RADS system classification standard, there were 3 cases of Class A, 40 cases of Class B, 84 cases of Class C, and 14 cases of Class D. According to the BI-RADS rating crite-ria, the two diagnosticians used four diagnostic modalities (DBT-CC, DBT-MLO and DBT (CC + MLO) combined with FFDM and FFDM alone for the diagniosis, respectively). Conclusion The false positive rate and false negative rate of the results in both monomer and bibody positions were lower than FFDM, the accuracy, specificity and sensitivity of diagnosis were higher than FFDM, the diagnostic efficacy of FFDM + DBT bibody position was higher than that of high/low-aged diagnosticians FFDM + DBT, the accuracy, sensitivity and specificity MLO between FFDM + DBT-CC, and FFDM + DBT-MLO were higher than CC position.

关 键 词：乳腺癌 数字乳腺断层合成技术 乳腺X线摄影 

分 类 号：R737.9[医药卫生—肿瘤] R445.4[医药卫生—临床医学]