三维超声冠状面结构扭曲与全视野数字乳腺X线摄影结构扭曲的一致性评估  

Assessment of consistency between coronal architectural distortion in three-dimensional ultrasonography and full-field digital mammography

作　　者：谭艳娟 黄安茜 俞丽芳 朱罗茜 包凌云 Tan Yanjuan;Huang Anqian;Yu Lifang;Zhu Luoxi;Bao Lingyun(Department of Ultrasound,Affiliated Hangzhou First People's Hospital,School of Medicine,Westlake University,Hangzhou 310006,China)

机构地区：[1]西湖大学医学院附属杭州市第一人民医院超声科,杭州310006

出　　处：《中华超声影像学杂志》2025年第3期225-231,共7页Chinese Journal of Ultrasonography

基　　金：浙江省医药卫生科技计划项目(2023KY942);杭州市生物医药和健康产业发展扶持科技专项(2022WJC247)。

摘　　要：目的:探讨三维超声(3D-US)冠状面结构扭曲(AD)与全视野数字乳腺X线摄影(FFDM)AD的一致性,分析3D-US冠状面AD的影响因素。方法:回顾性分析2019年1月至2021年12月于西湖大学医学院附属杭州市第一人民医院有3D-US检查结果且乳腺FFDM显示为AD的96例女性患者(97个病变)的资料。采用Kappa一致性检验分析3D-US冠状面AD与FFDM AD的一致性。比较3D-US冠状面有AD组与无AD组间乳腺FFDM病灶内特征(腺体密度、有无钙化及扭曲程度)、3D-US特征(是否多个病灶、有无肿块或非肿块病灶,冠状面有无跳跃征)及临床病理特征(年龄、部位、病理)的差异,并采用多因素Logistic回归分析筛选3D-US冠状面AD的影响因素。结果:乳腺FFDM AD病变中3D-US冠状面有AD 62个(63.92%,62/97),其中恶性30个(48.39%,30/62);无AD35个(36.08%,35/97),其中恶性4个(11.43%,4/35)。FFDM扭曲程度与3D-US一致性中等(Kappa=0.455,P<0.001),差异无统计学意义(χ^(2)=2.882,P=0.143)。有典型AD时恶性概率较不典型AD高。3D-US冠状面有AD组与无AD组间年龄、部位、病灶数量、3D-US跳跃征、腺体密度及病灶内是否伴有钙化差异无统计学意义(均P>0.05),病理结果良恶性、3D-US是否伴病灶(肿块及非肿块病灶)及FFDM内的扭曲程度差异有统计学意义(均P<0.05)。多因素Logistic回归分析显示3D-US冠状面AD的出现无独立危险因素(均P>0.05)。结论:乳腺FFDM AD病变中3D-US冠状面AD出现率63.92%,FFDM扭曲程度与3D-US一致性中等,有典型AD时恶性概率更高。病理恶性、3D-US伴有病灶(肿块及非肿块病灶)及FFDM内典型AD时3D-US冠状面有AD可能性更大。Objective:To evaluate the consistency between architectural distortion(AD)observed on coronal images in three-dimensional ultrasonography(3D-US)and full-field digital mammography(FFDM),and to analyze the influencing factors of the presence of AD on 3D-US coronal images.Methods:A retrospective study was conducted on 96 female patients(97 lesions)with AD identified via FFDM that examined at Affiliated Hangzhou First People's Hospital,School of Medicine,Westlake University from January 2019 to December 2021,all of which with corresponding 3D-US results.Kappa analysis was used to assess the consistency between AD on 3D-US and FFDM.The differences of the lesion characteristics on FFDM(glandular density,presence of calcifications,and degree of distortion),3D-US features(number of lesions,presence of mass or non-mass lesions,and skipping sign in coronal images),clinical pathological characteristics(age,location,and pathology)between groups with AD and without AD in 3D-US were compared.Multivariate Logistic regression was used to identify the influencing factors.Results:Among the FFDM-identified AD lesions,62(63.92%,62/97)lesions showed AD on 3D-US coronal images,including 30 malignant lesions(48.39%,30/62);35(36.08%,35/97)lesions without AD on 3D-US,in which 4(11.43%,4/35)were malignant.The consistency of distortion degree between FFDM and 3D-US was moderate(Kappa=0.455,P<0.001),with no statistically significant difference(χ^(2)=2.882,P=0.143).The probability of malignancy was higher in typical AD compared to atypical AD.The comparisons of age,location,number of lesions,presence of skipping sign in 3D-US,breast density,and presence of calcification in the lesion showed no statistically significant differences between the groups with and without AD(all P>0.05).The pathological results of malignancy,presence of lesions in 3D-US(mass and non-mass lesions),and the degree of distortion in FFDM showed statistically significant differences(all P<0.05).The multivariate Logistic regression analysis indicated that there were no

关 键 词：超声检查 乳腺肿瘤 乳腺X线摄影 结构扭曲 

分 类 号：R737.9[医药卫生—肿瘤]