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目的探讨乳腺触觉成像(palpationimaging,PI)对乳腺疾病的诊断价值。方法对2010年10月至2011年3月在上海交通大学医学院附属瑞金医院乳腺外科就诊的151例病人共计213个病灶,行PI、B超、钼靶及磁共振成像(MRI)检查,各检查方法独立进行。以病理诊断为金标准,通过受试者工作特征曲线(ROC曲线)评估PI对乳房病灶的诊断价值,并比较不同方法诊断结果的差异。结果 PI对病灶的良恶性具有较好的诊断价值(AUC=0.832,95%CI:0.766～0.898,P<0.001),敏感度为87.0%,显著高于钼靶(63.5%,P=0.005),与B超(87.0%)及MRI(94.0%)相比差异无统计学意义。PI的特异度及准确率为69.8%与74.2%,与钼靶相比差异无统计学意义(80.5%,P=0.041,未达到调整后检验水准α’=0.0083;75.4%,P=0.778),但显著低于B超(86.2%,P<0.001;86.4%,P=0.002)及MR(I85.7%,P=0.005;88.7%,P<0.001)。结论 PI对于乳房疾病具有良好的诊断价值,有望成为乳腺疾病现有辅助检查外的又一种重要检查方法。

The value of palpation imaging in the diagnosis of breast diseases

Objective To assess the value of palpation imaging(PI) in the diagnosis of breast diseases.Methods From October 2010 to March 2011,151 patients with 213 breast lesions,of which 54 were breast cancers and 159 were benign lesions,were examined by PI,ultrasound,mammography and magnetic resonance imaging(MRI) in Comprehensive Breast Health Center,Ruijin Hospital,Shanghai Jiaotong University.Receiver operating characteristic(ROC) curve was drawn to determine the cutoff value of the PI test.The diagnostic value of the four examinations were compared.Results The AUC value of the ROC curve was 0.832(95%CI:0.766 ～ 0.898,P <0.001) in the diagnostic tests of PI.The sensitivity of PI was 87.0%,which is higher than that of mammograghy(63.5%,P =0.005) significantly and not statistically different compared with ultrasound(87.0%) or MRI(94.0%).The specificity and acuracy of PI(69.8%,74.2%) was similar to that of mammography(80.5%,P =0.041,α ’ =0.0083;75.4%,P =0.778),but lower than that of ultrasound(86.2%,P <0.001;86.4%,P =0.002) and MRI(85.7%,P =0.005;88.7%,P <0.001) significantly.Conclusion PI is capable of differentiating benign and malignant breast lesions,and may become an important supplement of ultrasound,mammography and MRI in the diagnosis of breast diseases.