钼铑双靶乳腺X线摄影剂量优先模式与标准模式对照研究

目的：探讨钼铑双靶剂量优先模式在乳腺低辐射剂量检查中的价值。方法利用钼铑双靶乳腺机,对40例乳腺癌患者双侧乳腺分别进行头尾位(CC)和内外斜位(MLO)位标准模式和剂量优先模式摄影,对比分析160幅乳腺图像质量,分别记录平均腺体剂量(AGD)值和皮肤入射剂量(ESE)值。结果2种乳腺摄影模式均获得良好的图像质量,经检验两者间无显著性差异(χ2=0.427,P >0.05)。与标准模式相比,剂量优先模式摄影 CC 位 AGD 值降低约28.63%,ESE 值降低约28.28%,两者间具有显著性差异(t AGD =12.928,P <0.05,t ESE =8.850,P <0.05);MLO 位 AGD 值降低约26.33%,ESE 值降低约29.43%,两者间具有显著性差异(t AGD =11.006,P <0.05,t ESE =8.400,P <0.05)。结论在获取同等乳腺图像质量的情况下,钼铑双靶乳腺 X 射线摄影检查中剂量优先模式较标准模式能够有效降低受检者的辐射剂量。     

乳腺癌的钼靶X线诊断

目的：探讨钼靶X线摄片对乳腺癌的诊断价值。材料与方法：回顾性分析45例经手术病理证实的乳腺癌X线征象。结果：直接征象：肿块或结节29例，钙化16例；间接征象：腺体结构紊乱，皮肤增厚内陷，乳头内陷，Cooper氏韧带角状增粗。乳后间隙模糊或消失等。结论：乳腺钼靶X线摄片是检查乳腺癌的主要手段，分析不同组织学和不同病期的钼靶X线表现有利于提高乳腺癌的诊断准确率。     

乳腺癌钼靶X线征象探讨

目的　探讨乳腺癌X线各种征象 ,提高钼靶X线对乳腺癌诊断的准确性。方法　对 48例经病理证实的乳腺癌X线表现作回顾性分析。结果　 48例乳腺癌X线直接显示肿块影 3 8例 ,钙化灶 3 6例 ,大导管相 6例 ,厚皮征 3例 ,漏斗征 4例 ,异常血管 5例 ,塔尖征 6例 ,牛角征 8例。结论　钼靶X线乳腺摄影是诊断乳腺癌的首选方法 ,结合乳腺癌各种X线征象分析 ,一般可做出正确诊断。     

乳腺癌钼靶X线误诊分析

乳腺癌是女性常见的恶性肿瘤之一,近年来,乳腺癌的发病率及死亡率呈逐年上升趋势.在乳腺的诸多检查方法中,钼靶X线检查被公认为最主要和最有效的检查方法[1].为进一步提高乳腺癌的影像诊断水平,作者回顾性分析12例经手术并病理证实的乳腺癌X线误诊的原因,现报告如下.     

乳腺钼靶X线摄影技术的临床应用

乳腺铝靶X线摄影,是针对乳腺本身的组织结构以腺体和脂肪为主,密度对比小的特点,以金属钼为靶面,在管电压40KV以下,产生低能X线.是一种专门应用于乳腺检查的特殊X摄影技术.     

乳腺癌的钼靶X线摄影与计算机后处理

本文报告使用ASR-3000钼靶乳腺X线机乳腺摄影时的投照条件、体位与冲洗条件。结果：除病灶为致密增生的致密影遮盖的4例由超声检查检出外，各例乳癌的结节影或细小钙化影都得以清晰显示。乳腺X线机与CR设备结合，应用IP板代替胶片记载影像信息，经读取装置读出再转换为数字信息经计算机处理与图像重建，能增强病灶信息。抑制致密增生腺体的信息而增高病灶的检出率，故明显提高诊断的准确率与扩大诊断范围。     

数字钼靶X线诊断乳腺癌分析

目的 探讨数字钼靶X线摄影在诊断乳腺癌中的价值.方法 回顾性分析36例经病理证实的乳腺癌的数字钼靶X线片.结果 X线显示肿块22例(61.1%),肿块伴钙化7例(19.4%),不对称性密度增高伴结构紊乱4例(11.1%),Pagets病1例(2.7%),仅有钙化者3例(8.33%),异常血管影3例(8.33%),皮肤增厚4例(8.73%).结论数字钼靶X线摄影对乳腺癌早期诊断及鉴别诊断有重要意义.     

高频X线钼靶摄影对乳腺病变的诊断价值

目的探讨乳腺钼靶摄影在乳腺癌诊断中的应用价值。方法回顾性分析经手术、病理证实,资料较完整的46例乳腺癌的钼靶X线表现。结果46例乳腺癌X线表现直接显示肿块35例,占76．09％;钙化24例,占52．17％;局限性致密及结构紊乱5例,占10．87％;大导管相6例,占13．04％;乳头内陷8例,占17．39％;异常血管7例,占15．23％。结论乳腺钼靶摄影在乳腺癌的诊断中具有很较高的应用价值。     

钼靶及钼铑双靶对乳腺平片的质量评估

乳腺疾病是女性的一类常见病，乳房发生疾病后，病人不仅有身体上的痛苦，而且有精神上的负担。特别是乳腺癌可能缩短病人生命，为了早期发现妇女的乳腺疾病，我院引进了钼铑双靶X线机进行乳腺摄影。     

Clinical impact of BI-RADS classification in Taiwanese breast cancer patients: BI-RADS 5 versus BI-RADS 0-4

Objective

The aim of this study was to analyze and determine the prognostic value of the Breast Imaging Reporting and Data System (BI-RADS) classification in Taiwanese patients with breast cancer.

Patients and methods

Nine hundred ninety-eight patients with breast cancer were diagnosed between January 1, 1999, and August 31, 2005, and 491 (49%) of them were classified as BI-RADS 5. Overall survival and disease-free survival were estimated with the Kaplan–Meier method and compared across the two groups (BI-RADS 5 versus BI-RADS 0–4) using the log-rank test. Univariate and multivariate analyses were used to identify the prognostic factors.

Results

The median follow-up time was 81.8 months. Kaplan–Meier analysis showed a significant difference between the two subgroups in five-year overall survival (P = 0.001) and five-year disease-free survival (P < 0.0001). On univariate analysis, the mammographic findings (BI-RADS 5 versus BI-RADS 0–4) were statistically significantly associated with five-year overall survival and disease-free survival, as were tumor size, lymph-node status, tumor grade, estrogen-receptor status, progesterone-receptor status, and HER-2 status. On multivariate analysis, only the mammographic findings, lymph-node status, HER-2 status, and tumor grade were significant factors related to five-year overall survival and disease-free survival.

Conclusion

The BI-RADS classification is a reliable prognostic and predictive factor. Patients with BI-RADS 5 breast cancer showed a worse pattern of relapse than that of BI-RADS 0–4 breast cancer patients.     

术前超声及钼靶BI-RADS分类对早期乳腺癌的诊断价值

 目的 探索术前超声及钼靶BI-RADS分类对早期乳腺癌的诊断价值。方法 收集2015-08至2017-08在医院确诊为早期乳腺癌(TNM分期为Ⅰ、Ⅱ期)且术前同时行超声及钼靶检查的43例患者资料,共44个病灶。以BI-RADS分类≤3判为良性,=4a为可疑恶性,≥4b判为恶性,回顾性分析超声、钼靶及两者联合对早期乳腺癌的诊断价值。结果 早期乳腺癌术前超声BI-RADS分类判为可疑恶性及恶性的比例为93.2%(41/44),明显高于钼靶75.0%(33/44),差异有统计学意义(P＜0.05),两者联合诊断比例为95.5%(42/44)。其中对于黏液腺癌,超声判读为可疑恶性及恶性的比例明显高于钼靶,而浸润性导管癌、导管内癌及其他类型乳腺癌超声与钼靶BI-RADS分类无差异。其中两者联合仍判为良性的2个病灶分别为导管内癌和髓样癌。结论 对于早期乳腺癌尤其是黏液腺癌,术前超声BI-RADS分类判为可疑恶性及恶性的比例较钼靶更高;术前超声和钼靶判为可疑恶性及恶性的比例与乳腺癌病理类型密切相关;而对于特殊类型的早期乳腺癌及导管内癌两者结合仍有可能漏诊。     

钼靶X线、超声组合BI-RADS分类法指导农村妇女乳腺普查

目的:探讨应用钼钯X线(MAM)、超声(US)组合BI-RADS分类法确定农村妇女乳腺癌普查年龄的可行性。方法:954例本地区农村妇女,年龄35～60岁,平均(47.5±5.8)岁。所有妇女均接受US和MAM检查并行BI-RADS分类,US+MAM组合分类结果为每例受检者US与MAM分类结果中的最高级别,US+MAM分类Ⅲ类以上结果判定为高危人群并随访。将954例农村妇女及所检出的高危妇女划分为35～40岁、41～50岁、51～60岁3个年龄段,计算高危妇女在其相应年龄段所占比率,统计学分析其差异。结果:44例农村妇女被组合BI-RADS分类法评价为高危妇女,其随访结果与BI-RADS要求相符,35～40岁、41～50岁、51～60岁3个年龄段高危妇女所占比率分别为8.21%、5.32%、1.70%,其差异有统计学意义(P<0.05)。结论:应用US+MAM组合法BI-RADS分类可准确判定农村妇女乳腺癌的普查年龄。     

乳腺实质X线分型法与BI-RADS分类法在农村妇女乳腺癌筛查中的相关性研究

目的:探讨乳腺实质X线分型法(mammographic parenchymal patterns,MPP)与乳腺影像报告和数据系统法(breast imaging reporting and data system,BI-RADS)在农村妇女乳腺癌筛查中分类结果的相关性及应用意义。方法:2 619例本地区农村妇女,其X线检查结果行MPP分型和BI-RADS分类法分类,将MPP的Ⅲc、Ⅳc型及BI-RADS分类法Ⅲ^Ⅴ类定为高危患者。对BI-RADS分类Ⅰ、Ⅱ类的MPP高危妇女,随访2年后重新行BI-RADS分类,比较2种分类方法的关联性及随访差异。结果:2 619例农村妇女MPP所得各型结果及其包含BI-RADS分类法高危结果:Ⅰa 66例/5例,Ⅰb 189例/3例;Ⅱa 354例/6例,Ⅱb 96例/1例;Ⅲa 153例/6例,Ⅲb 132例/1例,Ⅲc 93例/6例;Ⅳa 474例/14例,Ⅳb 564例/45例,Ⅳc 66例/9例。2种分类方法关联分析有意义(P<0.05),Spearman秩相关分析无意义(P>0.05)。207例BI-RADS分类非高危的MPP高危妇女,随访有6例BI-RADS分类评价为高危(P<0.05)。结论:MPP用于农村妇女乳腺癌筛查有意义,与BI-RADS分类法所得结果有关联,但不密切。     

钼靶X线摄片在乳腺癌诊断中的应用价值

目的讨论钼靶X线对诊断乳腺癌的应用价值。方法回顾性分析17例经手术病理证实的乳腺癌X线表现,包括直接征象和间接征象。结果17例乳腺癌患者的X线征象:肿块见于15例,占88.24%,钙化8例,占47.06%,乳腺导管扩张2例,占11.7%,乳晕增厚7例,占41.18%,乳头凹陷8例,占47.06%,乳后间隙肿块3例,占17.65%,液下淋巴结肿大8例,占47.06%。结论钼靶X线摄影是诊断乳腺癌的首选方法。     

Computer-aided classification of BI-RADS category 3 breast lesions

PURPOSE: To evaluate a system for computer-aided classification (CAC) of lesions assigned to Breast Imaging Reporting and Data System (BI-RADS) category 3 at conventional mammographic interpretation. MATERIALS AND METHODS: A CAC system was used to analyze 106 cases of lesions (42 malignant) that at blinded retrospective interpretation were assigned to BI-RADS category 3 by at least two of four radiologists. The CAC system automatically extracted from the digitized mammograms quantitative features that characterized the lesions. The system then used a classification scheme to score the lesions by the likelihood of their malignancy on the basis of these features. The classification scheme was trained with 646 pathologically proved cases (323 malignant), and the results were tested with receiver operating characteristic (ROC) analysis by using the jackknife method. Sensitivity, specificity, positive predictive value, and accuracy were calculated. Category 3 lesions were stratified among BI-RADS categories 2-5 according to CAC-assigned lesion score, and this classification was compared with the results of pathologic analysis. RESULTS: Jackknife analysis of CAC results in the training data set yielded a sensitivity of 94%, specificity of 78%, positive predictive value of 81%, and area under the ROC curve of 0.90. Of the 42 malignant lesions that had been classified at conventional interpretation as probably benign, nine were assigned by the CAC system to BI-RADS category 4, and 29 were assigned to category 5. The CAC system correctly upgraded the BI-RADS classification of these 38 lesions (sensitivity, 90%) and incorrectly upgraded the classification of only 20 benign lesions (specificity, 69%). CONCLUSION: The CAC system scored 38 of the 42 malignant lesions initially assigned to BI-RADS category 3 as BI-RADS category 4 or 5, and thus correctly upgraded the category in 90% of these lesions.     

乳腺钼靶计算机X线摄影的临床应用

目的:探讨乳腺钼靶计算机X线摄影在乳腺检查中的优越性.方法:272例患者,行乳腺钼靶计算机X线摄影,对其照片进行分析、评价.结果:乳腺钼靶计算机X线摄影的满意率、阳性率分别为100%和83.8%.结论:将普通钼靶X线机与CR系统结合实现了乳腺检查的半数字化,具有良好的诊断效果.     

Intraobserver interpretation of breast ultrasonography following the BI-RADS classification

Purpose

To use the BI-RADS ultrasound classification in an intraobserver retrospective study of the interpretation of breast images.

Materials and Methods

The study used 40 breast ultrasound images recorded in orthogonal planes, obtained from patients with an indication for surgery. Eight professionals experienced in breast imaging analysis retrospectively reviewed these lesions, in three rounds of image interpretation (with a 3-6 months interval between rounds). Observers had no access to information from medical records or histopathological results, and, without their knowledge, in each new round were assigned the same images previously interpreted by them. Fleiss-modified Kappa measures were the study main concordance index. Besides the BI-RADS, a scale grouping its categories 2-3 and 4-5 was also used. The statistical analysis concerned the intraobserver agreement.

Results

Kappa values ranged from 0.37 to 0.75 (original categories) and from 0.73 to 0.87 (grouped categories). Overall, out of the 8 observers, 7 presented moderate to substantial concordance (Kappa values 0.51 to 0.74).

Conclusion

The BI-RADS is a reporting tool that provides a standardized terminology for US exams. In this study, moderate to substantial concordance in Kappa values was found, in agreement with other studies of the literature.     

Content-based image retrieval applied to BI-RADS tissue classification in screening mammography

AIM:To present a content-based image retrieval(CBIR) system that supports the classification of breast tissue density and can be used in the processing chain to adapt parameters for lesion segmentation and classification.METHODS:Breast density is characterized by image texture using singular value decomposition(SVD) and histograms.Pattern similarity is computed by a support vector machine(SVM) to separate the four BI-RADS tissue categories.The crucial number of remaining singular values is varied(SVD),and linear,radial,and polynomial kernels are investigated(SVM).The system is supported by a large reference database for training and evaluation.Experiments are based on 5-fold cross validation.RESULTS:Adopted from DDSM,MIAS,LLNL,and RWTH datasets,the reference database is composed of over 10000 various mammograms with unified and reliable ground truth.An average precision of 82.14% is obtained using 25 singular values(SVD),polynomial kernel and the one-against-one(SVM).CONCLUSION:Breast density characterization using SVD allied with SVM for image retrieval enable the development of a CBIR system that can effectively aid radiologists in their diagnosis.