摘要
目的评估乳腺断层摄影(DBT)对结构扭曲(AD)型病灶的诊断价值。方法回顾性分析2018年8月至2019年10月于陕西省肿瘤医院放射科行全视野数字乳腺X线摄影(FFDM)和DBT的112例有AD型病灶的患者资料,共126处AD型病灶的影像学资料纳入分析。采用χ^(2)检验比较FFDM和DBT对AD型病灶检出能力的差别。根据超声检查BI-RADS分类结果,将病灶分为有超声相关征象组(BI-RADS 4A类及以上)和无超声相关征象组(BI-RADS 1~3类),采用χ^(2)检验比较2组患者间病理结果分布及乳腺癌比例的差别。结果FFDM检出80处AD型病灶,DBT检出126处,DBT检出率高于FFDM[100%(126/126)比63.5%(80/126),χ^(2)=56.272,P<0.001]。126处AD型病灶中恶性病灶45处、良性病灶40处和高风险病灶41处。有超声相关征象组(82处)与无超声相关征象组(44处)的病理诊断结果比较,差异有统计学意义(χ^(2)=20.502,P<0.001)。有超声相关征象组中恶性病灶占比为48.8%(40/82),而无超声相关征象组中恶性病灶占比为11.4%(5/44),2组间比较,差异有统计学意义(χ^(2)=17.461,P<0.001)。FFDM未显示而仅DBT检出的46处AD型病灶中,有超声相关征象组(21处)与无超声相关征象组(25处)的病理诊断结果比较,差异有统计学意义(χ^(2)=7.672,P=0.022),2组内恶性病灶占比比较差异无统计学意义[33.3%(7/21)比12.0%(3/25),χ^(2)=3.053,P=0.081]。结论DBT检出乳腺内AD型病灶的能力高于FFDM。超声检查提示BI-RADS 4A类及以上的AD型病灶恶性可能性更大。
Objective To evaluate digital breast tomosynthesis(DBT)in the diagnosis of architectural distortion(AD)lesions.Methods The imaging data of 112 female patients with 126 AD lesions detected by DBT and full-field digital mammography(FFDM)in the Department of Radiology,Shaanxi Provincial Cancer Hospital between August 2018 and October 2019 were collected for a retrospective study.χ^(2) test was used to compare the detection rate of AD between FFDM and DBT.According to the ultrasound BIRADS grading,the lesions were divided into two groups:ultrasound-related group(BI-RADS 4A and above)and unrelated group(BI-RADS 1-3).The pathological results and the proportion of malignant lesions were compared between two groups byχ^(2) test.Results Totally 80 AD lesions were detected by FFDM and 126 by DBT.The detection rate of AD by DBT was significantly higher than that by FFDM[100%(126/126)vs 63.5%(80/126),χ^(2)=56.272,P<0.001].Among the 126 AD lesions,45 were malignant lesions,40 were benign lesions and 41 were high-risk lesions.There was a significant difference in the pathological results between ultrasound-related group(82 lesions)and unrelated group(44 lesions)(χ^(2)=20.502,P<0.001).The proportion of malignant lesions was 48.8%(40/82)in ultrasound-related group,11.4%(5/44)in unrelated group,indicating a significant difference(χ^(2)=17.461,P<0.001).Among the 46 AD lesions only detected by DBT,the pathological results presented a significant difference between ultrasound-related group(21 lesions)and unrelated group(25 lesions)(χ^(2)=7.672,P=0.022),while there was no significant difference in the proportion of malignant lesions between two groups[33.3%(7/21)vs 12.0%(3/25),χ^(2)=3.053,P=0.081].Conclusions The detection rate of AD by DBT was significantly higher than that by FFDM.The AD lesion of BI-RADS 4A and above on ultrasonography shows a higher probability of malignancy.
作者
马佳琪
梁秀芬
闫斌
邓颖
戴强
马晶
刘瑾
袁权
程颢
朱江
陆建荣
Ma Jiaqi;Liang Xiufen;Yan Bin;Deng Ying;Dai Qiang;Ma Jing;Liu Jin;Yuan Quan;Cheng Hao;Zhu Jiang;Lu Jianrong(Department of Radiology,Shaanxi Provincial Cancer Hospital,Xi’An 710061,China;Department of Ultrasonography,Shaanxi Provincial Cancer Hospital,Xi’An 710061,China;Department of Mastopathy,Shaanxi Provincial Cancer Hospital,Xi’An 710061,China;Department of Pathology,Shaanxi Provincial Cancer Hospital,Xi’An 710061,China)
出处
《中华乳腺病杂志（电子版）》
CAS
CSCD
2022年第5期292-297,共6页
Chinese Journal of Breast Disease(Electronic Edition)
基金
陕西省自然科学基金资助项目(S2020-JC-QN-0986)
陕西省科技攻关计划资助项目(S2020-YF-YBSF-0023)。
作者简介
通信作者:梁秀芬,Email:379652968@qq.com。
