乳腺X线摄影、彩色多普勒超声及多层螺旋CT检查在乳腺肿块诊断中的应用价值  

The Value of Mammography,Color Doppler Ultrasound and Multislice Spiral CT Examination in the Diagnosis of Breast Masses

作　　者：冯晶晶[1] 程南生[1] 金张龙 张大伟 FENG Jingjing;CHENG Nansheng;JIN Zhanglong;ZHANG Dawei(Department of Imaging,Anqing First People’s Hospital,Anhui 246003,China)

机构地区：[1]安庆市第一人民医院影像科,安徽246003

出　　处：《影像科学与光化学》2025年第2期3-10,46,共9页Imaging Science and Photochemistry

基　　金：2022年度安徽省卫生健康科研立项项目(AHWJ2022c030)。

摘　　要：目的:探讨乳腺X线摄影、彩色多普勒超声及多层螺旋CT检查在乳腺肿块诊断中的应用价值。方法:回顾性分析我院2020年1月至2024年1月期间收治的94例乳腺肿块患者影像资料,均行乳腺X线摄影、彩色多普勒超声及多层螺旋CT检查,以手术病理结果为金标准,将其分为恶性组(n=53)和良性组(n=41)。根据乳腺影像报告和数据系统(BI⁃RADS)分类,分析乳腺X线摄影、彩色多普勒超声对不同BI⁃RADS分类检出率及多层螺旋CT检查乳腺肿块征象特征;计算准确率、灵敏度及特异度,绘制ROC曲线,评估单一及联合诊断鉴别乳腺肿块良恶性性能。结果:乳腺X线摄影诊断显示,恶性组与良性组4类检出率对比差异有统计学意义(P<0.05)。彩色多普勒超声诊断显示,恶性组与良性组3类、4类、5类检出率对比差异均有统计学意义(P<0.05)。多层螺旋CT诊断结果显示,良性组与恶性组征象特征对比差异有统计学意义(P<0.05)。以病理诊断结果为金标准,联合诊断准确率(95.74%)显著高于乳腺X线摄影(76.60%)、彩色多普勒超声(84.04%)、多层螺旋CT(65.96%),差异有统计学意义(X^(2)=14.462、P=0.000;X^(2)=7.084、P=0.008;X^(2)=26.936,P=0.000)。联合诊断灵敏度(98.11%)高于乳腺X线摄影(90.57%)、彩色多普勒超声(88.68%),特异度(92.68%)高于彩色多普勒超声(78.05%),阳性预测值(94.55%)高于彩色多普勒超声(83.93%),差异无统计学意义(P>0.05);联合诊断灵敏度高于多层螺旋CT(84.91%),特异度高于乳腺X线摄影(58.54%)、多层螺旋CT(41.46%),阳性预测值高于乳腺X线摄影(73.85%)、多层螺旋CT(65.22%),阴性预测值(97.44%)高于乳腺X线摄影(82.76%)、彩色多普勒超声(84.21%)及多层螺旋CT(68.00%),差异均有统计学意义(P<0.05)。ROC结果显示单一及联合诊断乳腺肿块差异均具有统计学意义(P<0.05),其中联合诊断AUC为0.954,95%CI为0.903~1.000。结论:乳腺X线摄影、彩色多普勒超声及多层螺旋CT�Objective:Exploring the value of mammography,color Doppler ultrasound and multislice spiral CT examination in the diagnosis of breast masses.Methods:We retrospectively analyzed the imaging data of 94 patients with breast masses admitted to our hospital between January 2020 and January 2024,who underwent mammography,color Doppler ultrasound,and multislice spiral CT,and classified them into malignant(n=53)and benign(n=41)groups,using the results of surgical pathology as the gold standard.According to the breast imaging reporting and data system(BI⁃RADS)classification,the detection rates of mammography,color Doppler ultrasound for different BI⁃RADS classifications and the characteristics of breast mass signs on multislice spiral CT were analyzed;the accuracy,sensitivity and specificity were calculated,and ROC curves were plotted to evaluate the performance of single and combined diagnostics in identifying benign and malignant breast masses.Results:Mammography diagnosis showed that the difference in the detection rate of category 4 between the malignant group and the benign group was statistically significant(P<0.05).Color Doppler ultrasound diagnosis showed that the difference in the detection rate of category 3,4 and 5 between the malignant group and the benign group was statistically significant(P<0.05).The diagnostic results of multislice spiral CT showed that the difference in symptomatic characteristics between the benign group and the malignant group was statistically significant(P<0.05).Using the pathological diagnostic results as the gold standard,the combined diagnostic accuracy(95.74%)was significantly higher than that of mammography(76.60%),color Doppler ultrasound(84.04%),and multislice spiral CT(65.96%),with a statistically significant difference(X^(2)=14.462、P=0.000;X^(2)=7.084、P=0.008;X^(2)=26.936,P=0.000).The sensitivity of combined diagnosis(98.11%)was higher than that of mammography(90.57%)and color Doppler ultrasound(88.68%),the specificity(92.68%)was higher than that of color Doppler ultr

关 键 词：乳腺X线摄影 多层螺旋CT 彩色多普勒超声 乳腺肿块 联合诊断 

分 类 号：R814.4[医药卫生—影像医学与核医学] R737.9[医药卫生—放射医学]