Identifying elderly women with osteoporosis by spinal dual X-ray absorptiometry, calcaneal quantitative ultrasound and spinal quantitative computed tomography: a comparative study

The ability of spinal dual x-ray absorptiometry (DXA), calcaneal quantitative ultrasound (QUS) and spinal quantitative computed tomography (QCT) to identify women with osteoporosis within the GISELA study was evaluated in 43 women, aged 62-87 years. Osteoporosis was defined as a T-score below or equal to -2.5 using DXA (femoral neck). To determine the performance of each method, the sensitivity, specificity and area under the curve (by means of a receiver operating characteristic [ROC] analysis) were calculated. The median T-scores from the measurements differed significantly (p < 0.0001). DXA (spine) identified 75% of women with osteoporosis; QUS and QCT identified 100%. The specificity was 89% for DXA (spine), 66% for QUS and 29% for QCT. ROC analysis showed that all three methods are qualified to identify women with osteoporosis; however, the different sensitivities and specificities of the methods, as well as the thresholds used for diagnosing osteoporosis have to be considered. (E-mail: monika.neuhaeuser-berthold@ernaehrung.uni-giessen.de)     

Validation of body composition by dual energy X-ray absorptiometry (DEXA)

Summary. The present study validates the use of dual energy X-ray absorptiometry (DEXA) for measurement of body composition. The precision error was expressed as the SD (CV%) for fat mass, FAT%, lean tissue mass, and total body bone mineral: 1·1 kg (6·4%), 1·6% (5·7%), 1·4 kg (3·1%), and 0·03 kg (1·2%), respectively. The accuracy study in vitro used (1) mixtures of water and alcohol, (2) mixtures of ox muscle and lard, and (3) dried bones. In the clinically relevant range of values there were only small influences on DEXA measurements of variations in amount and composition of the soft tissue equivalents. The accuracy study in vivo compared the components of body composition measured recently by DEXA and earlier by dual photon absorptiometry, counting of naturally occurring total body ⁴⁰K, and body density by underwater weighing in 25 healthy adult subjects. We found agreement between fat percentage (and lean body mass) by DEXA and the three established measurements modalities; mean differences were (-5·3 to -0·4%) and (-0·7 to 2·5 kg) for fat percentage and lean body mass, respectively. We conclude that DEXA provides a new method of measuring body composition with precision and accuracy errors, which are compatible with the application of DEXA in group research studies and probably also in clinical measurements of the single subject.     

骨超声衰减与双能X线吸收法测量骨密度的相关性研究

目的： 探讨跟骨宽带超声衰减诊断骨质疏松的临床价值。方法： 对一组５３ 例绝经期老年女性用超声衰减成像扫描仪测量左跟骨宽带超声衰减 （ＢＵＡ）, 并用双能Ｘ 线吸收法 （ＤＥＸＡ） 测量其腰椎Ｌ２－Ｌ４ 骨密度 （ＢＭ ＤＬ２－Ｌ４） 及右髋骨密度 （ＢＭ ＤＨ）, 将上述两种方法所测得的参数进行相关分析。结果： 左跟骨 ＢＵＡ 与腰椎ＢＭ Ｄ 呈中度相关 （ｒ＝ ０．６６１, Ｐ＜ ０．０００１）, 左跟骨ＢＵＡ 与右髋ＢＭ Ｄ 呈中度相关 （ｒ＝ ０．６１８, Ｐ＜ ０．０００１）, 左跟骨ＢＵＡ 与腰椎ＢＭ Ｄ、右髋ＢＭ Ｄ 诊断骨质疏松齐同率为８６．８％ 。结论： 跟骨ＢＵＡ 是评价骨密度的有效指标, 超声衰减成像技术是临床诊断骨质疏松的又一实用的新方法。     

Representativity of regional to total bone mineral in healthy subjects and 'anticonvulsive treated' epileptic patients. Measurements by single and dual photon absorptiometry

Dual photon (153Gd) and single photon (125I) absorptiometry were used to measure the regional bone mineral content (BMC) and density (BMD), as well as the total body mineral content (TBBM) and density (TBBD), in sixty-nine healthy subjects and in twenty-three epileptics on phenobarbitone. The BMCs (and BMDs) of all regions were significantly correlated to each other and to the TBBM (and TBBD). No difference in the ability to discriminate between the different study groups was found for the various regions, excepting the BMD of the head. The relationship between the forearm BMC and TBBM was highly significant, and identical in the five groups. The relationships between spinal BMC and forearm BMC, and TBBM differed in the five groups. It is concluded that some local measurement may be used as estimates of the total body bone mineral in some groups of patients with minor metabolic bone disease and healthy subjects.     

青壮年甲状腺功能亢进患者的骨密度变化

目的:观察青壮年甲状腺功能亢进患者骨矿物质含量的变化.方法:采用双能X线吸收法测量84例青壮年甲亢患者(甲亢组)和84例与其年龄和性别匹配的正常健康者(对照组)的全身、正位腰椎(L2-4)和左侧股骨近端(包括股骨颈、大粗隆、髋关节)骨矿物质密度(BMD),并同时测量血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平.结果:在未接受治疗的84例青壮年甲亢患者中,女性有51.7%(30/58)存在骨矿含量异常,其中骨量减少和骨质疏松的发生率分别为36.2%(21/58)和15.5%(9/58);男性有46.2%(12/26)存在骨矿含量异常,其中骨量减少和骨质疏松的发生率分别为15.4%(4/26)和30.8%(8/26).甲亢组的全身、L2-4和左侧股骨近端BMD(除外男性L2～4,P＞0.05)低于对照组(P＜0.01).甲亢组病程、血清FT3、FT4含量与全身、L2～4、左侧股骨近端BMD值呈负相关(除外男性L2～4,P＞0.05).结论:甲亢是青壮年男、女性低骨量和骨质疏松的主要风险因素之一.     

Ability of ultrasound bone profile score (UBPS) to discriminate between fractured and not fractured osteoporotic women

In this study, we evaluated the ability of different quantitative ultrasound (QUS) parameters (speed of sound, SOS, coefficient of variation, CV, = 0.34% and broadband ultrasound (US) attenuation, BUA, CV = 3.25% measured at the heel by an Hologic Sahara unit; Ad-Sos and ultrasound bone profile score (UBPS) at the proximal phalanges by an Igea DBM Sonic 1200 unit, Ad-Sos CV = 0.57%) to detect differences between osteoporotic patients with vertebral fractures and osteoporotic patients without fractures. We examined 87 women with primary osteoporosis: 53 women with femoral neck bone mineral density (BMD) T scores less than -2.5 SD and no vertebral fractures and 34 women with one or more vertebral fractures, regardless of T score values. Considering all the patients together, the correlations between QUS parameters and BMD resulted in statistical significance (p < 0.05) only for BUA and femoral neck BMD. Lumbar and femoral neck BMD did not statistically differ between the two groups, while UBPS, which is a quality control of measurement and is correlated with bone quality, was significantly higher in women without fractures than those with fractures; the other QUS parameters were not statistically different. Our data indicate that, among QUS parameters, only UBPS is able to detect differences among osteoporotic patients with and without vertebral fractures.     

青壮年甲状腺功能亢进患者的骨代谢特征

目的：通过对初发的青壮年甲状腺功能亢进症（甲亢）患者的骨密度（BMD）的测定,研究甲亢患者骨代谢的特征。方法采用双能X线吸收法对我院369例初发未经治疗的青壮年甲亢患者组和148名健康对照组进行腰椎L2-4,股骨近端的BMD检测,同时测定甲状腺功能、AKP、PTH、CT、24 h尿钙、血钙等。结果比较甲亢组与健康对照组的FT3、FT4和TSH差异有统计学意义（P0.05）;甲亢骨量正常组24 h尿钙与对照组比较差异无统计学意义（P〉0.05）,而甲亢骨量异常组24 h尿钙与对照组比较有显著性差异（P〈0.05）;甲亢患者BMD与血清FT3、FT4呈负相关,与TSH呈正相关。结论通过甲状腺功能、骨密度及骨代谢指标的研究分析,发现甲亢将导致青壮年骨量减少和骨质疏松,因此在治疗甲亢时,不应忽略对骨质疏松的预防。     

Estimation of wrist fracture load using phalangeal speed of sound: an in vitro study

This study aimed to evaluate the ability of speed of sound (SOS) measured at the phalanges to estimate simulated wrist fracture load and stress. SOS was measured along the proximal phalanges of the second, third and fourth fingers using an ultrasound (US) system operating in axial transmission mode. The bone mineral density (BMD) of the radius and the phalanges was also measured with quantitative computed tomography (QCT) and dual x-ray absorptiometry (DXA), and the combined cortical thickness (CCT) of the phalanges was measured from hand radiographs. After the measurements were completed, the radius was excised from the cadaver, embedded in polymethylmethacrylate and tested to failure on a servohydraulic testing machine. The configuration of the radius was chosen to simulate a fall onto the hand. Linear regression analysis showed a highly significant correlation between SOS (r = 0.76–0.94, p < 0.001), CCT (r = 0.86–0.90, p < 0.001) and BMD (r = 0.92–0.96, p < 0.0001) in the three proximal phalanges measured. SOS, BMD and CCT were significant predictors of fracture load (r = 0.60–0.69, p < 0.03) and stress (r = 0.65–0.77, p < 0.02). Cortical area and bone mineral content (BMC) of the radius were consistently higher predictors of fracture load (r = 0.76–0.82, p < 0.01 for area and R = 0.78–0.88, p < 0.01 for BMC) than BMD. The correlation of BMC and area was poorer with fracture stress. In a step-wise regression analysis using both phalangeal BMD and SOS, only SOS remained a significant predictor of fracture stress. In forward stepwise regression analysis, both cortical area and SOS were entered into the regression model to estimate fracture load. Only SOS remained significant in the model for estimating fracture stress. Phalangeal BMD was only entered in the combined model with the cortical area at the 4% site (r = 0.84, p = 0.002). Phalangeal SOS is a useful parameter in the assessment of bone status of the radius.     

Comparison of the Bod Pod and dual energy x-ray absorptiometry in men

The majority of studies investigating the accuracy of the Bod Pod have compared it to hydrostatic weighing (HW), the long held, and perhaps outdated 'gold standard' method of body composition analysis. Much less research has compared the Bod Pod to dual energy x-ray absorptiometry (DXA), a technique that is becoming popular as an alternative reference method. The purpose of this study was to compare per cent fat estimates by the Bod Pod to those of DXA in a large number of men. Participants were 160 men (32 +/- 11 years). Per cent body fat was estimated to be 19.4 +/- 6.8 and 21.6 +/- 8.4 for DXA and the Bod Pod, respectively. Although the two methods were highly correlated (0.94), the mean difference of 2.2% was significant (p < 0.01). The amount of difference increased as body fatness increased (p < 0.0001). The results of this study indicate that a difference between methods existed for our sample of men. It is uncertain exactly where the difference lies. Practitioners should be aware that even with the use of technologically sophisticated methods (i.e., Bod Pod, DXA), differences between methods exist and the determination of body composition is at best, an estimation.     

热固耦合式超声骨强度仪的可重复性及相关性研究

目的:评估一款国产热固耦合式超声骨强度仪的可重复性和有效性。方法:选择11名志愿者,用该仪器测得右跟骨的两个超声参数,分别是超声速度(SOS)和宽带超声衰减(BUA),计算每个参数的变异系数均方根百分比(CVRMS%),评估该仪器的短期可重复性;选择18名志愿者,用类似的方法评估该仪器的中期可重复性;选择29名志愿者,用双能X线吸收法(DEXA)测量腰椎骨密度(BMD),并与用该仪器测得的跟骨SOS,BUA值进行相关性分析,评估该仪器的有效性。结果:①超声参数SOS,BUA的短期CVRMS%分别为0.30,4.24;中期CVRMS%分别为0.41,4.20。②SOS与腰椎BMD的相关系数r=0.486(P<0.01),BUA与腰椎BMD的相关系数r=0.629(P<0.01)。结论:与国际主流定量超声(QUS)检测仪器相比,热固耦合式超声骨强度仪具有较高的可重复性和准确性,可用于临床骨质状况评估。     

Estimation of wrist fracture load using phalangeal speed of sound: an in vitro study

This study aimed to evaluate the ability of speed of sound (SOS) measured at the phalanges to estimate simulated wrist fracture load and stress. SOS was measured along the proximal phalanges of the second, third and fourth fingers using an ultrasound (US) system operating in axial transmission mode. The bone mineral density (BMD) of the radius and the phalanges was also measured with quantitative computed tomography (QCT) and dual x-ray absorptiometry (DXA), and the combined cortical thickness (CCT) of the phalanges was measured from hand radiographs. After the measurements were completed, the radius was excised from the cadaver, embedded in polymethylmethacrylate and tested to failure on a servohydraulic testing machine. The configuration of the radius was chosen to simulate a fall onto the hand. Linear regression analysis showed a highly significant correlation between SOS (r = 0.76–0.94, p < 0.001), CCT (r = 0.86–0.90, p < 0.001) and BMD (r = 0.92–0.96, p < 0.0001) in the three proximal phalanges measured. SOS, BMD and CCT were significant predictors of fracture load (r = 0.60–0.69, p < 0.03) and stress (r = 0.65–0.77, p < 0.02). Cortical area and bone mineral content (BMC) of the radius were consistently higher predictors of fracture load (r = 0.76–0.82, p < 0.01 for area and R = 0.78–0.88, p < 0.01 for BMC) than BMD. The correlation of BMC and area was poorer with fracture stress. In a step-wise regression analysis using both phalangeal BMD and SOS, only SOS remained a significant predictor of fracture stress. In forward stepwise regression analysis, both cortical area and SOS were entered into the regression model to estimate fracture load. Only SOS remained significant in the model for estimating fracture stress. Phalangeal BMD was only entered in the combined model with the cortical area at the 4% site (r = 0.84, p = 0.002). Phalangeal SOS is a useful parameter in the assessment of bone status of the radius.     

广东湛江地区老年人骨密度及骨质疏松患病率的初步调查

目的探讨湛江地区老年人骨密度（BMD）现状,为广东粤西沿海地区老年人骨质疏松症的防治提供科学依据。方法①采用美国Hologic QDR 4500A型双能X线骨密度仪对480例老年人的腰椎及髋部进行测量及分析。②按年龄、性别输入数据,以5岁为1个年龄组,分别计算骨密度。结果①60、70、80岁男性第2～4腰椎BMD分别为0.932、0.870、0.739,女性分别为0.831、0.707、0.647。②60、70、80岁男性Neck和Ward’s区BMD分别为0.752和0.683、0.734和0.650、0.671和0.593;女性分别为0.724和0.650、0.617和0.568、0.556和0.482。③60、70、80岁骨质疏松患病率男性为15.1%、28.9%和25.0%,女性为24.0%、47.5%和62.5%,女性骨质疏松患病率高于男性,差异有统计学意义（P〈0.05）。结论湛江地区老年人随着年龄的增加,男、女性腰椎和髋骨的骨密度逐渐下降。骨质疏松患病率随年龄增加而上升,同龄女性组骨质疏松患病率高于男性组。     

DR双能量减影技术在胸部病变的诊断价值

目的探讨双能量减影在胸部直接数字化X线摄影技术的临床应用价值。方法随机抽取83例胸部双能量减影数字化X线摄影（DR）。83例病人均进行胸部后前位片的双能量减影的图像后处理,形成标准DR图像、软组织减影图像、骨骼减影图像各一幅即所谓的“骨肉分离”技术。结果由于双能量减影去除了骨性胸廓的干扰,增加肺部检出钙化的敏感性和准确性,增加肺结节的检出率,对肺部的良、恶性定性有意义;对骨性胸廓病变的诊断更加准确;对肺结节的检出率较普通胸片明显提高。双能量减影对显示骨性胸廓和中央气道的病变,如骨转移瘤、骨折、骨质破坏、钙化等较常规胸片、单纯直接数字化摄影均有明显提高,统计学有明显差异。双能量减影图像上肉眼判断有、无钙化非常可靠。结论双能量减影直接数字化X线摄影技术提供了更多的影像诊断信息,增加了诊断的准确性的信心,具有较高的实用临床价值和推广价值。     

双能X线骨密度仪在15 cm水深中测量骨密度的准确性

目的探讨双能X线骨密度仪(dual energy X-ray absorptiometry,DXA)测量骨密度的准确性.方法用DXA(前后位扫描)测量5具浸泡在15 cm水深中的猪腰段脊柱,共计20例椎骨,计算测量的结果与灰重及灰重密度相关性.结果骨矿含量与灰重呈显著正相关性(r=0.95,P＜0.01),而骨密度与灰重无明显相关性(r=0.41,P＞0.05).结论DXA测量骨密度中骨矿含量较准确,而骨密度较差.     

Longitudinal changes in ultrasound measurements: a parallel study in subjects with genetic disorders and healthy controls

Disturbances in skeletal status in subjects with genetic disorder may increase their fracture risk. The aim of the study was longitudinal observation of phalangeal speed of sound changes across the bone over a period of 2 y in 24 patients (14 boys and 10 girls, mean age 9.63 +/- 1.8 y.) and 24 age-matched healthy controls (14 boys and 10 girls, mean age 9.65 +/- 1.71 y.). Weight and height did not differ between patients and controls at baseline and follow-up. Patients with the following disorders were evaluated: 7 with Down syndrome, 6 nonspecific mental retardations of unknown etiology, 5 Martin-Bell syndrome and 6 with other diseases. In patients and controls, no factors potentially influencing bone metabolism (except for genetic disorder) were present. Bone status was assessed by quantitative ultrasound at hand phalanges using DBM Sonic 1200 (IGEA, Carpi, Italy), which measures amplitude-dependent speed of sound (Ad-SoS [m/s]). At baseline, Ad-SoS and Z-score were significantly lower in patients than in controls (1892 +/- 51 m/s versus 1936 +/- 43 m/s, p < 0.01 and -1.47 +/- 1.43 versus -0.14 +/- 1.04, p < 0.001, respectively. In follow-up, Ad-SoS and Z-score increased significantly in patients (1892 +/- 51 m/s to 1934 +/- 48 m/s, p < 0.0001 and -1.47 +/- 1.43 to -0.76 +/- 1.00, p < 0.01, respectively) and in controls (1936 +/- 43 m/s to 1976 +/- 60 m/s and -0.14 +/- 1.04 to 0.31 +/- 1.08, p < 0.05, respectively). Follow-up Ad-SoS and Z-Score were significantly lower in patients (p < 0.01). Longitudinal changes in Ad-SoS, Z-score weight did not differ between patients and control, and height increased more in controls (13.2 +/- 2.8 cm versus 11.4 +/- 5.9 cm, p < 0.05)+). In patients, Ad-SoS increased by 42 m/s (2.22%), and in controls increased by 40 m/s (2.07%). Difference in Ad-SoS between patients and controls was 44 m/s at baseline and 42 m/s at follow-up. Using the value of the least significant change (LSC = 20.5 m/s), in 16 patients (67%) and in 18 controls (75%) Ad-SoS showed an increase greater than the LSC, in one control (4%) a decrease greater than the LSC and in rest of subjects studied remained unchanged (33% patients and 19% controls) over a period of observation. In conclusion, despite comparable improvement in measured ultrasound parameter in patients and controls observed over a study duration, the difference between them remained stable.     

双能量CT对急性痛风结晶的评估及相关因素分析

目的:采用单源双能量CT(dual energy CT,DECT)处理技术测定痛风性关节炎患者急性发作时的尿酸盐结晶沉积量多少,评估其临床诊断价值,探讨尿酸盐结晶及相关影响因素.方法:选取2018年1月—2020年12月在高新区人民医院因急性痛风性关节炎住院的116例拟诊患者的病例资料并进行分析.所有患者均接受关节DE...     

彩色多普勒超声及钼靶X射线检查在乳腺癌诊断中的应用价值

目的探讨彩色多普勒超声及钼靶X射线检查在乳腺癌诊断中的应用价值,为临床诊断方法的选择提供参考。方法选取2018年1月至2019年6月在我院就诊的乳腺疾病患者76例为研究对象,所有患者均行彩色多普勒超声及钼靶X射线检查,并详细记录影像学资料,将检查结果与病理学检查结果进行比较。结果76例乳腺疾病患者中,确诊乳腺癌患者31例,其余45例为乳腺良性肿瘤患者。联合检查的准确率为93.42%(71/76),高于彩色多普勒超声的75.00%(57/76)及钼靶X射线检查的84.21%(64/76),差异具有统计学意义(P<0.05)。联合检查诊断乳腺癌的灵敏度和特异度高于单一彩色多普勒超声检查和单一钼靶X射线检查,但仅灵敏度存在显著差异(P<0.05)。结论彩色多普勒超声和钼靶X射线检查在乳腺癌的诊断中均有一定的优势,二者联合使用可有效提高乳腺癌的诊断准确率。     

双频谱多普勒超声成像技术评价左心室乳头肌与附着室壁心肌机械力学时空关联性

目的运用双频谱多普勒超声成像技术评价左心室二尖瓣乳头肌与附着室壁心肌机械力学时空关联性。 方法选择2012年5至6月四川省人民医院经体格检查、心电图和超声心动图检查结果无异常,无高血压、心肌梗死、心脏瓣膜疾病及其他心血管疾病相关病史的健康志愿者112名。应用双频谱多普勒超声成像技术于心尖左心室长轴切面或心尖四腔心切面和心尖二腔心切面同步获取左心室二尖瓣前外侧乳头肌（APM）、后内侧乳头肌（PPM）中段及其乳头肌基底部所附着心室壁的心肌组织运动速度频谱,在同一心动周期内同步测量对应两位点心肌组织运动速度收缩期峰值速度（s′）、舒张早期峰值速度（e′）、舒张晚期峰值速度（a′）,以心电图R波峰尖为时间起点,记录其对应达峰时间St、Et、At。采用配对t检验分别比较APM、PPM与其基底段附着室壁心肌组织、APM与PPM的s′、e′、a′、St、Et、At差异;采用Pearson相关分析分析APM、PPM与其基底段附着室壁心肌组织s′、e′、a′、St、Et、At的相关性及APM与PPM的St、Et、At的相关性。 结果与其基底段附着室壁心肌组织比较,APM的e′、a′均较高、s′均较低,且差异均有统计学意义（t值分别为-2.75、7.76、2.65,P均<0.01）;与其基底段附着室壁心肌组织比较,PPM的e′、a′均较高,且差异均有统计学意义（t值分别为11.74、3.31,P均<0.01）;s′的差异无统计学意义。与其基底部附着室壁心肌组织比较,APM、PPM的Et较小,且差异有统计学意义（t值分别为-8.57、-8.36,P均<0.01）;St、At的差异均无统计学意义。与APM比较,PPM的s′较低,St较长,且差异均有统计学意义（t值分别为2.74、-7.34,P均<0.01）;而e′、a′、Et、At差异均无统计学意义。APM与其基底段附着室壁s′、e′、a′均呈显著正相关（r=0.83、0.77、0.66,P均为0.000）;PPM与其基底段附着室壁s′、e′、a′也均呈显著正相关（r=0.86、0.81、0.79,P均为0.000）。APM与其基底段附着室壁St、Et、At均呈显著正相关（r=0.80、0.98、0.98,P均为0.000）;PPM与其基底段附着室壁St、Et、At也均呈显著正相关（r=0.82、0.99、1.00,P均为0.000）。APM与PPM的St、Et、At均呈显著正相关（r=0.34、0.91、0.88,P均为0.000）。 结论左心室APM、PPM与其附着室壁心肌运动状态存在一致的时空变化规律,两者间舒张期和收缩期心肌峰值运动速度存在差异;两组乳头肌间舒张期心肌峰值运动速度和达峰时间具有较高的同步性和相关性,收缩期心肌运动状态存在明显差异。     

Quantitative ultrasound of the heel and serum and urinary cortisol values in assesment of long-term corticotherapy side effects in female bronchial asthma patients

Female asthma patients (26) with and without corticotherapy were studied. The control group included 19 healthy women. Skeletal status was assessed by ultrasound measurement of the heel (Achilles, Lunar, Madison, WI, USA) and serum and urinary corisol expressed adrenal function. Ultrasound and hormonal values were significantly lower in patients treated with glucocorticosteroids (GC) than in controls. In patients without GC, cortisol parameters were normal and ultrasound measurements were moderately diminished. 57% of women with and 33% of women without GC-therapy had an ultrasound T-score less than −2.5. Decrease of ultrasound values estimated by linear regression in relationship to time of asthma duration was highest in women with GC therapy. Several significant coefficients of correlation between ultrasound and adrenal function parameters were noted only in patients treated with GC. These data suggest that bone and endocrinological side effects due to steroid therapy in asthma patients show similar trends. Results obtained in present study require further longitudinal investigations.     

X线钼靶联合彩色多普勒超声在乳腺癌筛查中的应用价值

目的探究X线钼靶联合彩色多普勒超声在乳腺癌筛查中的应用价值。方法选择经X线钼靶及彩色多普勒超声检查并经病理学证实为乳腺癌患者109例(126个病灶),对其影像学诊断资料进行回顾性分析,分别计算彩色多普勒超声与X线钼靶及联合诊断符合率。结果109例乳腺癌患者合计126个病灶,其中93例单发乳腺癌,29例为多中心型或多灶型乳腺癌,4例双乳癌;彩色多普勒超声联合X线钼靶诊断、彩色多普勒超声和X线钼靶诊断符合率分别为96.83%、84.92%、79.37%,彩色多普勒超声联合X线钼靶诊断明显高于单一的彩色多普勒超声与X线钼靶诊断,差异均有统计学意义(χ^2分别=10.77、18.31,P均<0.05),彩色多普勒超声与X线钼靶诊断符合率比较,差异无统计学意义(χ^2=1.33,P>0.05)。彩色多普勒超声检查浸润性导管癌、导管原位癌、浸润性小叶癌诊出率较高,X线钼靶漏诊率较高;X线钼靶对10个肿块中细小毛刺可清晰显示,但彩色多普勒超声仅对其中3例进行描述;X线钼靶确定微小钙化灶27例,彩色多普勒超声仅对其中13例进行显示。结论X线钼靶与彩色多普勒超声诊断乳腺癌符合率均较低,但X线钼靶联合彩色多普勒超声诊断乳腺癌能起到互补作用,大幅度提升诊断符合率,筛查联合应用效果较好。