乳腺叶状肿瘤的锥光束乳腺CT影像特征分析  

Analysis of cone-beam breast computed tomography imaging features of phyllodes tumor

作　　者：黄彩云 苏丹柯[1] 钟武宁 赵阳[1] 韦苇[1] 康巍[1] HUANG Caiyun;SU Danke;ZHONG Wuning;ZHAO Yang;WEI Wei;KANG Wei(Department of Radiology,Guangxi Medical University Cancer Hospital,Nanning 530021,China;Department of the Breast,Bone and Soft Tissue Oncology,Guangxi Medical University Cancer Hospital)

机构地区：[1]广西医科大学附属肿瘤医院放射科,南宁530021 [2]广西医科大学附属肿瘤医院乳腺及骨软组织部肿瘤内科

出　　处：《国际医学放射学杂志》2024年第4期452-457,共6页International Journal of Medical Radiology

基　　金：广西自然科学基金区域高发疾病研究联合专项资助项目(2023GXNSFBA026247,2023GXNSFBA026283,2023GXNSFBA026035);广西医科大学青年科学基金资助项目(GXMUYSF 202227);广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20220734,Z-A20220738)。

摘　　要：目的探讨不同病理级别乳腺叶状肿瘤(PTB)的锥光束乳腺CT(CBBCT)影像特征,以提高其对该病的诊断能力。方法回顾性收集经手术病理证实为PTB的女性病人33例,平均年龄(44.9±11.5)岁。所有病人均于术前行CBBCT检查,分析PTB的影像特征,测量病灶的最大径、CT值、强化率,并绘制时间-密度曲线(TDC)。根据不同病理级别将病人分为良性组(15例)和恶性组(18例)。采用Kappa检验和组内相关系数(ICC)分析2名医师主观评阅及定量测量的一致性。采用Fisher确切概率检验、独立样本t检验及Mann-Whitney U检验比较不同病理级别PTB的CBBCT影像特征及增强参数的差异。结果2名医师对不同病理级别PTB影像特征分析及参数测量结果均具有较高的一致性(Kappa值为0.761~0.939、ICC为0.805~0.983,均P<0.05)。相比良性组,恶性组中边缘模糊、有肿瘤血管征的病灶占比更高,增强1期的CT值更高,增强2期的强化率更低(均P<0.05)。2组间其余CBBCT影像征象差异均无统计学意义(均P>0.05)。结论不同病理级别乳腺PTB的CBBCT表现有一定的特征性,可根据病灶边缘、肿瘤血管征、增强1期CT值、增强2期强化率进行鉴别。Objective To explore the cone-beam breast computed tomography(CBBCT)imaging features of phyllodes tumor of the breast(PTB)at different pathological grades,aiming to enhance the diagnostic ability for this disease.Methods A total of 33 female patients with PTB confirmed by surgical pathology were retrospectively collected,with a mean age of 44.9±11.5 years.All patients underwent CBBCT examination before surgery,and the imaging features of PTB were analyzed,measuring the maximum diameter,CT value,and the enhancement rate of the lesions,and the time-density curve(TDC)was plotted.Based on pathological grades,the patients were divided into a benign group(15 cases)and a malignant group(18 cases).Kappa test and intra-class correlation coefficient(ICC)were used to analyze the consistency of subjective assessment and quantitative measurements by two radiologists.The Fisher exact test,independent samples t-test,and Mann-Whitney U test were used to compare the CBBCT imaging features and enhancement parameters of PTB at different pathological grades.Results There was a high consistency between the two radiologists in the imaging feature analysis and parameter measurements of PTB with different pathological grades(Kappa=0.761-0.939,ICC=0.805-0.983,all P<0.05).Compared with the benign group,the malignant group had a higher proportion of lesions with blurred boundary and tumor vessel sign,higher CT value in the first enhanced phase,and lower enhancement rates in the second enhancement stage(all P<0.05).There were no significant differences in the other CBBCT imaging features between the two groups(all P>0.05).Conclusion PTB at different pathological grades have certain characteristics on CBBCT imaging.Differentiation can be made based on boundary,tumor vessel sign,the CT value in the first enhanced phase,and the enhancement rate in the second enhancement stage.

关 键 词：乳腺叶状肿瘤 锥光束乳腺CT 鉴别诊断 

分 类 号：R737.9[医药卫生—肿瘤] R814.42[医药卫生—临床医学]