数字化钼靶X线与扩散加权成像联合动态对比增强对乳腺导管原位癌及浸润癌诊断的价值  

Value of digital molybdenum target X-ray and diffusion-weighted imaging combined with dynamic contrast-enhanced imaging in the diagnosis of ductal carcinoma in situ and invasive carcinoma of the breast

作　　者：孔丹青 丁玲[1] 李文燕 于大飞[1] 张玉忠[1] KONG Danqing;DING Ling;LI Wenyan;YU Dafei;ZHANG Yuzhong(Department of Medical Imaging,The People's Hospital of Longhua,Shenzhen,Affiliated to Southern Medical University,Shenzhen 518109,China)

机构地区：[1]南方医科大学附属深圳市龙华区人民医院医学影像科,广东深圳518109

出　　处：《分子影像学杂志》2024年第4期397-402,共6页Journal of Molecular Imaging

基　　金：深圳市龙华区医疗卫生机构区级科研项目(2022163)。

摘　　要：目的探讨数字化钼靶X线(DM)与扩散加权成像(DWI)联合动态对比增强(DCE)对乳腺导管原位癌(DCIS)及浸润癌(IDC)诊断的价值。方法回顾性分析2021年1月~2022年12月在南方医科大学附属深圳市龙华区人民医院接受DM、DWI和DCE检查的49例乳腺癌患者的影像资料,根据病理结果将其分为DCIS组(n=20)和IDC组(n=29),比较两组在DM、DWI和DCE上的表现差异,计算各种影像学指标的诊断效能,采用Kappa检测评定诊断方法之间的一致性情况。结果DCIS组与IDC组患者在钙化、肿块、弥散系数(ADC)、信号强度、内部强化情况、周围强化情况的差异有统计学意义(P<0.05);DM检测出16例(80.00%)DCIS、25例(86.21%)IDC。DW检测出17例(85.00%)DCIS、27例(93.10%)IDC。DCE检测出18例(90.00%)DCIS、27例(93.10%)IDC。DM+DWI+DCE联合检测出19例(95.00%)DCIS、28例(96.55%)IDC。DM检查结果总符合率为83.67%,DWI检查结果总符合率为89.80%,DCE检查结果总符合率为91.84%。而DM+DWI+DCE联合检查的总符合率为95.92%,均高于DM、DWI、DCE单独检查的总符合率。Kappa一致性检验结果显示DM+DWI+DCE对DCIS与IDC的鉴别诊断具有良好的一致性(P<0.05)。结论DM、DWI和DCE联合应用对乳腺DCIS和IDC的诊断具有较高的价值,能够提高对DCIS和IDC的鉴别效能,有助于指导临床治疗和预后评估。Objective To explore the value of digital mammography(DM)combined with diffusion-weighted imaging(DWI)and dynamic contrast-enhanced imaging(DCE)in the diagnosis of ductal carcinoma in situ(DCIS)and invasive ductal carcinoma(IDC).Methods The imaging data of 49 patients with breast cancer who received DM,DWI and DCE examination in the People's Hospital of Longhua,Shenzhen,Affiliated to Southern Medical University from January 2021 to December 2022 was retrospectively analyzed.According to the pathological results,it was divided into DCIS group(n=20)and IDC group(n=29).The differences in performance between the two groups on DM,DWI and DCE were compared,and the diagnostic efficacy of various imaging indicators was calculated.Kappa test was used to evaluate the consistency between diagnostic methods.Results The differences in calcification,mass,diffusion coefficient(ADC),signal intensity,internal enhancement,and peripheral enhancement between the DCIS group and the IDC group were statistically significant(P<0.05),DM detected 16 cases of DCIS and 25 IDC cases.DW detected 17 cases of DCIS and 27 IDC cases.DCE detected 18 cases of DCIS and 27 IDC cases.The combination of DM,DWI,and DCE detected 19 cases of DCIS and 28 IDC cases.The total compliance rate of DM examination results was 83.67%;The total compliance rate of DWI examination results was 89.80%the total compliance rate of DCE examination results was 91.84%the overall compliance rate of DM+DWI+DCE combined examination was 95.92%,which was higher than the overall compliance rate of DM,DWI and DCE alone examination.The Kappa consistency test results showed that DM+DWI+DCE had good consistency in the differential diagnosis of DCIS and IDC(P<0.05).Conclusion The combined application of DM,DWI,and DCE has high value in the diagnosis of breast DCIS and IDC,which can improve the differential efficiency of DCIS and IDC,and help guide clinical treatment and prognosis evaluation.

关 键 词：导管原位癌 浸润癌 数字化钼靶X线 扩散加权成像 动态对比增强 

分 类 号：R737.9[医药卫生—肿瘤] R730.44[医药卫生—临床医学]