摘要
目的探讨全屏数字化乳腺X线摄影(FFDM)、数字乳腺断层合成摄影(DBT)与MRI检查对乳腺癌的诊断效能。方法搜集2018年5月至2019年3月在安徽医科大学附属安庆医院行FFDM、DBT和MRI检查且经病理证实的54例乳腺癌和54例乳腺良性病变患者的影像及临床资料。以病理结果为金标准,参照2013版乳腺影像报告和数据系统(BI-RADS)对病变进行诊断、评估,采用受试者工作特征(ROC)曲线分析五种检查方法的诊断效能,利用Z检验比较DBT和MRI的统计学差异。结果108例患者发现54例良性病灶和54例恶性病灶。FFDM、DBT、MRI、FFDM+DBT和FFDM+MRI基于BI-RADS分类诊断乳腺良、恶性病变的ROC曲线的曲线下面积(AUC)分别为0.750、0.861、0.889、0.880和0.917;两两比较结果显示,其他四种检查方法的AUC均高于FFDM,且差异均有统计学意义(P<0.05);而这四种检查方法之间的AUC差异无统计学意义(P>0.05)。MRI的灵敏度高于DBT和FFDM(DBT高于FFDM),DBT特异度及阳性预测值高于MRI和FFDM。结论DBT或FFDM+DBT较FFDM均能显著提高乳腺癌的诊断效能,并与MRI或FFDM+MRI诊断效能相当,但是DBT的灵敏度低于MRI高于FFDM,特异度和阳性预测值高于MRI。FFDM+DBT和FFDM+MRI在一定程度上提高了乳腺癌的准确度,有助于乳腺癌的早期诊断。
Objective Exploring the diagnostic efficacy of full-field digital mammography(FFDM)、digital breast tomosynthesis(DBT)and MRI for breast cancer.Methods Imaging and clinical data of 54 patients with breast cancer and 54 patients with benign breast lesions who were examined by FFDM,DBT and MRI in Anqing Hospital affiliated to Anhui Medical University from May 2018 to March 2019 and confirmed by pathology,were collected.The pathological results were taken as the gold standard.The lesions were diagnosed and evaluated according to the 2013 BI-RADS version.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic performance of the five examination methods;the difference in the efficiency of DBT and MRI was determined by Z-test.Results There were 54 benign lesions and 54 malignant lesions in 108 breast patients.Area under the curve(AUC)of FFDM,DBT,MRI,FFDM+DBT and FFDM+MRI based on the BI-RADS was 0.750、0.861、0.889、0.880 and 0.917,respectively.The results showed that AUC of the other four methods were higher than FFDM,and the difference was statistically significant(P<0.05).There was no significant difference in AUC between the four methods(P>0.05).The sensitivity of MRI was higher than that of DBT and FFDM(DBT was higher than FFDM),and the specificity and positive predictive value of DBT were higher than that of MRI and FFDM.Conclusion DBT or FFDM+DBT could significantly improve the diagnostic efficacy of breast cancer compared with FFDM,providing a comparable efficiency to MRI or FFDM+MRI;However,The sensitivity of DBT was lower than that of MRI and higher than that of FFDM,and its specificity was higher than that of MRI.FFDM+DBT or FFDM+MRI could improve the accuracy of breast cancer to a certain extent and contribute to the early diagnosis of breast cancer.
作者
黄新玲
胡汉金
HUANG Xinling;HU Hanjin(Anqing Hospital affiliated to Anhui Meidical University,Anqing,Anhui Province 246003,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第6期1085-1089,共5页
Journal of Clinical Radiology
作者简介
通讯作者:胡汉金
