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1.
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χ2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χ2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),χ2=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(χ2=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(χ2=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(χ2=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),χ2=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。  相似文献   
2.
ObjectivesThe aim of this paper is to illustrate the current status of imaging in high breast density as we enter a new decade of advancing medicine and technology to diagnose breast lesions.Key findingsEarly detection of breast cancer has become the chief focus of research from governments to individuals. However, with varying breast densities across the globe, the explosion of breast density information related to imaging, phenotypes, diet, computer aided diagnosis and artificial intelligence has witnessed a dramatic shift in new screening recommendations in mammography, physical examination, screening younger women and women with comorbid conditions, screening women at high risk, and new screening technologies. Breast density is well known to be a risk factor in patients with suspected/known breast neoplasia. Extensive research in the field of qualitative and quantitative analysis on different tissue characteristics of the breast has rapidly become the chief focus of breast imaging. A summary of the available guidelines and modalities of breast imaging, as well as new emerging techniques under study that can potentially provide an augmentation or even a replacement of those currently available.ConclusionDespite all the advances in technology and all the research directed towards breast cancer, detection of breast cancer in dense breasts remains a dilemma.Implications for practiceIt is of utmost importance to develop highly sensitive screening modalities for early detection of breast cancer.  相似文献   
3.
《Radiography》2022,28(2):333-339
IntroductionDigital Mammography (DM-2D) and more recently Digital Breast Tomosynthesis (DBT), are two of the most effective imaging modalities for breast cancer detection, often used in screening programmes. It may happen that exams using these two imaging modalities are inadvertently performed to pregnant women. The objective of this study is to assess the dose in the uterus due to DM-2D and DBT exams, according to two main irradiation scenarios: in the 1st scenario the exposure parameters were pre-selected directly by the imaging system, while in the 2nd scenario, the maximum exposure parameters were chosen.MethodsThe mammography equipment used was a Siemens Mammomat Inspiration. A physical anthropomorphic phantom, PMMA plates (simulating a breast thickness of 6 cm) and thermoluminescent dosimeters (TLDs) were used to measure entrance air kerma values on the phantom's breast and abdomen in order to successively estimate the mean glandular dose (MGD) and the dose in the uterus. For the two irradiation scenarios chosen, two-breast imaging modalities were selected: 1) DBT in Cranio-Caudal (CC) view (with 28 kV and 160 mAs as exposure parameters), 2) DBT and DM in Medio Lateral-Oblique (MLO) and CC views (with 34 kV and 250 mAs as exposure parameters).ResultsIn the 1st scenario, the TLD measurements did not detect significant dose values in the abdomen whereas the MGD estimated using the D.R. Dance model was in close agreement with data available in the literature. In the 2nd scenario, there was no significant difference in MGD estimation between the different views, whereas the air kerma values in the abdomen (in DBT mode, CC and MLO) were 0.049 mGy and 0.004 mGy respectively. In CC DM-2D mode the abdomen air kerma value was 0.026 mGy, with no significant detected value in MLO view.ConclusionsFor the dose in the uterus, the obtained values seem to indicate that DM-2D and DBT examinations inadvertently performed during pregnancy do not pose a significant radiological risk, even considering the case of overexposure in both breasts.Implications for practiceThe accurate knowledge of the doses in DM-2D and DBT will contribute to raise the awareness among medical practitioners involved in breast imaging empowering them to provide accurate information about dose levels in the uterus, improving their radiation risk communication skills and consequently helping to reduce the anxiety of pregnant women undergoing this type of examinations.  相似文献   
4.
乳腺假血管瘤样间质增生(PASH)为一种良性间质细胞增生,属于肌纤维母细胞增生范畴。PASH常发生于绝经前及绝经后使用激素替代治疗的女性,需与低度恶性血管肉瘤、叶状肿瘤及纤维腺瘤鉴别。乳腺X线摄影、B超及核医学诊断PASH价值有限,但在乳腺MRI不同序列上PASH具有一定特点。对于疑诊PASH的病人,分析比较影像表现与穿刺活检病理表现是否一致非常重要。对PASH的临床表现、病理学特点及影像表现等予以综述。  相似文献   
5.
《Clinical breast cancer》2020,20(1):e82-e88
BackgroundClinical response evaluation by image examination after neoadjuvant chemotherapy for breast cancer is important for determining drug response and progression. Mammography is less correlated with pathologic response assessment than magnetic resonance imaging or ultrasonography. The present study clarified characteristics of breast cancer patients with decreased microcalcifications after neoadjuvant chemotherapy to increase the accuracy of mammographic assessment.Patients and MethodsConsecutive patients who received neoadjuvant chemotherapy for breast cancer at our hospital from January 2013 to June 2017 were retrospectively reviewed. Characteristics of cases of microcalcifications before neoadjuvant chemotherapy and those showing a reduction after were examined. Stromal tumor-infiltrating lymphocytes were evaluated in the biopsy. Pathologic complete response was also explored in patients exhibiting a decrease in microcalcifications by neoadjuvant chemotherapy.ResultsSeventy breast cancer cases were included; 37 had no malignant microcalcifications before neoadjuvant chemotherapy and 33 did. Breast cancer with microcalcifications was significantly more positive for human epidermal growth factor receptor 2 than those without microcalcifications (48% vs. 22%, P = .018). Only 6 of 33 patients with microcalcifications before neoadjuvant chemotherapy showed a decrease after treatment. These patients tended to have high stromal tumor-infiltrating lymphocytes (50% vs. 17%), segmental microcalcifications (66% vs. 33%), and pleomorphic/linear microcalcifications (83% vs. 37%).ConclusionThese results suggest that neoadjuvant chemotherapy is able to decrease malignant calcifications, particularly segmental and pleomorphic/linear microcalcifications. By clarifying the mechanisms of formation and disappearance of microcalcifications, a consensus can be reached on whether microcalcifications apparent by mammography are useful for evaluating response to neoadjuvant chemotherapy.  相似文献   
6.
《Radiography》2020,26(1):76-81
IntroductionTo measure mammography-related pain in two groups of women undergoing regular surveillance as a baseline for future care.MethodsFollowing ethical approval, two hundred and forty two women aged 32–84 years (mean 54), were invited by written invitation to participate in the study. Two hundred women accepted the invitation, 100 women had a family history (FH) of breast cancer, 100 had undergone conservative surgery (FU) for breast cancer and were currently asymptomatic. A validated pain scale was used to score the participants' perceived pain before compression based on memory, immediately after compression and one week later. A series of baseline parameters were also captured including compression force, breast size/density, menstrual history and any adverse events following mammography to allow the investigation of relationships.ResultsThere was a strong correlation (r = 0.79, p < 0.001) between previous pain scores and current pain scores, no significant correlations were found between breast size, breast density or total compression force and pain. Pain scores reduced between previous and current examinations and there was consistency in overall pain scores, despite variations in the compression forces applied.ConclusionPhysical side effects from mammography can develop and extend beyond the examination period. Patients' prior experience of pain was the only significant predictor of current pain in this study.Implications for practiceData on past mammography experiences are essential to improve future pain outcomes. Post-mammography aftercare should be a routine feature of the examination.  相似文献   
7.
目的探讨磁共振(MRI)动态增强扫描对乳腺钼靶摄影(MG)中含簇状钙化灶良恶性病变的诊断鉴别价值。方法回顾性分析我院2013年2月至2018年6月收治的80例含簇状钙化灶乳腺病变患者MRI及MG影像学资料,并与术后病理结果进行对比,计算MRI动态增强与MG联合诊断乳腺含簇状钙化灶良恶性病变效能。结果MG诊断共有恶性病灶35个,良性病灶51个,MG联合MRI共诊断出恶性病灶38个,良性病灶48个,两种检测方法恶性病灶检出比较差异无统计学意义(P>0.05);MG联合MRI对含簇状钙化灶良恶性病变诊断灵敏度94.59%,特异度93.88%,准确度94.19%,阳性预测值92.11%,阴性预测值95.83%高于单独MG检测灵敏度72.97%,特异度83.67%,准确度79.07%,阳性预测值77.14%,阴性预测值80.39%,差异有统计学意义(P<0.05)。结论MRI动态增强扫描对乳腺钼靶摄影中含簇状钙化灶良恶性病变的诊断价值高于单独的MG检测。  相似文献   
8.
ObjectiveThere is insufficient large-scale evidence for screening mammography in women <40 years at elevated risk. This study compares risk-based screening of women aged 30 to 39 with risk factors versus women aged 40 to 49 without risk factors in the National Mammography Database (NMD).MethodsThis retrospective, HIPAA-compliant, institutional review board–exempt study analyzed data from 150 NMD mammography facilities in 31 states. Patients were stratified by 5-year age intervals, availability of prior mammograms, and specific risk factors for breast cancer: family history of breast cancer, personal history of breast cancer, and dense breasts. Four screening performance metrics were calculated for each age and risk group: recall rate (RR), cancer detection rate (CDR), and positive predictive values for biopsy recommended (PPV2) and biopsy performed (PPV3).ResultsData from 5,986,131 screening mammograms performed between January 2008 and December 2015 in 2,647,315 women were evaluated. Overall, mean CDR was 3.69 of 1,000 (95% confidence interval: 3.64-3.74), RR was 9.89% (9.87%-9.92%), PPV2 was 20.1% (19.9%-20.4%), and PPV3 was 28.2% (27.0%-28.5%). Women aged 30 to 34 and 35 to 39 had similar CDR, RR, and PPVs, with the presence of the three evaluated risk factors associated with significantly higher CDR. Moreover, compared with a population currently recommended for screening mammography in the United States (aged 40-49 at average risk), incidence screening (at least one prior screening examination) of women aged 30 to 39 with the three evaluated risk factors has similar cancer detection rates and recall rates.DiscussionWomen with one or more of these three specific risk factors likely benefit from screening commencing at age 30 instead of age 40.  相似文献   
9.
目的:探究乳腺X线数字化处理对于疾病诊断的影响。方法选取72例女性患者为研究对象,将患者的乳腺X线片通过医用扫描仪进行数字化处理,并探讨数字化处理后的乳腺X线片对乳腺疾病诊断是否有影响。利用3名放射科医师分别对X线片与数字图像进行评析,将2次的读片结果ROC进行分析,计算平均Az值和平均差值。结果平均Az值分别为0.922和0.859,而两者平均差值仅为0.063,差异无统计学意义。结论数字化处理后的X线摄影对疾病诊断的影响尚无定论,恰当的数字化方式既能降低误诊、漏诊率,对使用 PACS系统影响效果显著。  相似文献   
10.
目的:探讨乳腺X线摄影、彩色多普勒超声及二者联合诊断乳腺病变的价值。方法:回顾性分析经术后病理证实的153例女性乳腺肿块的超声及乳腺X线影像学资料,分析二者诊断乳腺病变的影像特点。结果:153例中良性63例,恶性90例。两种检查方法联合应用对乳腺恶性肿块诊断敏感性为97.8%,特异性90.5%,准确性为94.8%,高于单用一种检查方法(P<0.05)。结论:乳腺超声和乳腺X线在乳腺肿块诊断中联合应用可以提高乳腺病变的检出率及准确率,为临床提供诊断依据。  相似文献   
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