浅谈CR在乳腺钼靶X线检查中的应用

目的：探讨CR在乳腺钼靶C线检查中的优越性。方法：对350例来我科作乳腺检查者随机分为两组，分别有56人和294人，作普通钼靶和经CR处理的数字化乳腺摄影，对其照片进行分析、评价。结果：普通钼靶摄影组的满意率、重摄率、阳性率分别为73．2％、26．8％和75％；数字化乳腺摄影组的满意率、重摄率、阳性率分别为100％、0％和83％。结论：现有普通钼靶X线机及CR系统的结合实现了乳腺检查的数字化，在乳腺疾病的检查中，其满意率、阳性率明显高于普通钼靶摄影，而重摄率明显低于普通钼靶摄影，其在现阶段的应用，不失为提高乳腺摄片质量、节约成本的一项良策。     

CR系统在乳腺钼靶摄影中的临床应用

目的：探讨计算机X线成像系统（CR系统）在乳腺钼靶X线摄影中的应用价值。方法：随机抽查屏／片乳腺片、CR钼靶乳腺图像各100份，比较两组照片的满意率、废片率、检出率和投照剂量。结果：普通钼靶摄影组的满意率、废片率、检出率分别为78％、2．8％和76％；数字化乳腺摄影组的满意率、废片率、检出率分别为99．7％、0和85％。CR系统仅用常规摄影剂量的1／5—1／10。结论：利用CR成像系统与钼靶摄影机的结合可以实现乳腺数字化摄影，效果优于普通屏／片摄影，在提高乳腺疾病的检出率方面更具优势，为临床早发现早治疗乳腺疾病提供了可靠依据。     

全野数字乳腺摄影系统在乳腺检查中的应用价值研究

目的:探讨全野数字乳腺摄影系统在乳腺检查中的应用价值。方法:收集我院进行乳腺检查患者321例进行研究评价,其中,CR乳腺摄影148例,全野数字乳腺摄影173例,分析评价检查时间、图像质量、诊断阳性率,乳腺癌的诊断敏感性、特异性、准确性。结果:CR乳腺摄影平均检查时间13.6min/人,甲级片率91%、诊断阳性率83.1%,其敏感性、特异性、准确性分别为86.8%、89.4%、88.6%。全野数字乳腺摄影系统平均检查时间5.7min/人,甲级片率97%,诊断阳性率92.5%,其诊断敏感性、特异性、准确性分别为91.8%、93.7%、93.1%。结论:全野数字乳腺摄影成像技术优于CR钼靶成像技术,且曝光剂量大大减少,提高了图像质量和乳腺疾病的诊断阳性率,减少了检查时间,乳腺癌的诊断敏感性、特异性、准确性都有提高。     

超声弹性成像与乳腺钼靶摄影对乳腺癌诊断的对比研究

目的:研究超声弹性成像与钼靶摄影对乳腺癌的诊断价值。方法:回顾性分析110个乳腺肿物,术前行超声弹性成像及乳腺钼靶摄影检查,以病理结果对照分析,计算两种方法诊断乳腺疾病的敏感性、特异性、准确性。结果:超声弹性成像诊断结节的敏感性、特异性、准确性分别是79.41%、78.94%、79.10%。乳腺钼靶摄影诊断结节的敏感性、特异性、准确性分别是68.75%、76.92%、74.55%,超声弹性成像与乳腺钼靶摄影诊断结果有统计学差异(P<0.01)。结论:超声弹性成像作为辅助诊断的模式之一,需结合钼靶摄影检查,有助于提高乳腺检查的准确性。     

X线摄影、彩色多普勒超声和立体定位穿刺对早期乳腺癌的诊断价值

目的 探讨X线摄影、彩色多普勒超声（简称彩超）和立体定位穿刺对早期乳腺癌的诊断价值,提高其诊断率。方法 55例早期乳腺癌和25例乳腺良性病变均行两侧X线摄影、彩超检查,再经立体定位穿刺,作病理学检查。结果 在55例早期乳腺癌中,X线钼靶摄影诊断早期乳腺癌45例,其敏感性和特异性分别为82．0％和88．0％;彩超诊断早期乳腺癌43例,其敏感性和特异性分别为78．2％和84．0％,准确性为80．0％;立体定位穿刺诊断早期乳腺癌53例,其敏感性和特异性分别为96．4％和92．0％,准确性为95．0％,无假阳性。综合影像诊断早期乳腺癌54例,其敏感性和特异性分别为98．2％和96．0％,准确性为97．5％。结论X线摄影、彩超和立体定位穿刺联合应用,可提高早期乳腺癌诊断的敏感性和准确性。     

钼靶X线摄影与1.5T MRI对乳腺良恶性肿块的诊断价值

目的 探讨钼靶X线摄影与MRI对乳腺良恶性肿块的诊断价值.方法 收集临床资料完整,经手术病理结果证实并于术前1～2周进行过临床触诊、钼靶X线摄影乳腺肿块138例,对48例X线表现不典型病例行MRI平扫及动态增强检查,并与手术病理结果做对照分析. 结果本组中恶性病变71例,良性病变67例.钼靶X线摄影的敏感性、特异性及准确性分别为81.69%、76.12%及78.99%.MRI结合平扫、DCE-MRI早期强化率及时间-密度曲线诊断,MRI检查的敏感性、特异性及准确性分别为87.50%、83.33%及85.42%. 48例患者MRI与钼靶X线摄影对病变的符合情况准确性比较具有统计学意义(χ2=4.063,P0.05).结论 钼靶X线摄影与1.5T MRI二者结合可明显提高乳腺良恶性肿块的诊断准确率.     

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.     

早期乳腺癌的超声和X线摄影的对照研究

目的 探讨早期乳腺癌的超声和X线的特征性表现,提高其诊断率。材料与方法 50例乳腺癌和20例乳腺良性病变均行B超和X线检查,乳腺摄片时间为月经后10天内,所有病例均经病理证实。结果 B超诊断早期乳腺癌39例,其敏感性和特异性分别为78．0％和85．0％,准确性为80．0％;X线诊断早期乳癌41例,其敏感性和特异性分别为82．0％和90．05,准确性为84．3％。二者综合诊断,其敏感性和特异性为96．0％和76．5％,准确性为90．4％。结论 二者综合检查可提高早期乳腺癌诊断的敏感性和准确性。     

数字乳腺摄影的计算机辅助诊断在乳腺癌筛查中的应用

目的:探讨数字钼靶乳腺摄影及计算机辅助诊断(CAD)在乳腺癌筛查诊断中的价值。方法:2010年1月至2011年1月我院数字乳腺钼靶摄片并经手术证实的40例纳入研究,包括乳腺癌35例(其中原位癌6例)和乳腺腺体增生5例。术前分别在普通显示器上读片诊断和工作站上使用CAD软件读片诊断,然后比较分析。结果:使用普通医用显示器的乳腺癌诊断的敏感性为71.4%,准确性75%;使用CAD分析的乳腺癌诊断的敏感性为88.6%,准确性90%。应用CAD对微钙化检出的敏感性明显高于普通医用显示器(P=0.032)。结论:数字乳腺摄影结合CAD有助于乳腺癌筛查诊断。     

小乳癌的数字化乳腺摄影与超声成像对比研究

目的探讨数字化乳腺摄影与彩色多普勒超声对小乳癌及腋淋巴结转移的诊断价值。方法60例≤2.0cm(包括未形成肿块的早期乳腺癌)乳腺结节的数字化影像和超声资料分别由影像和超声医师用双盲法分析,定性诊断,并与病理对照。结果60例中,乳腺癌36例,良性病变24例;发现腋淋巴结96个,45个有转移。数字化摄影和超声在诊断小乳癌的敏感性、准确性及腋淋巴结转移的敏感性方面,二者差异显著(P(0.05);对直径≤1.0cm的病灶,数字化摄影的准确性明显高于超声(P(0.05)。结论对小乳癌及其腋淋巴结的定性诊断方面,数字化摄影为首选,二者结合有利于发现更早期的乳腺癌。     

临床查体、乳腺超声及X线检查诊断中国人乳腺癌的评价

目的 评价临床查体、乳腺超声及X线检查在诊断中国人乳腺癌中的价值,并比较3种检查的灵敏度、特异度和准确度,分析其联合诊断的意义.方法 对同期乳腺普查和门诊发现的112例可疑乳腺癌的病例(普查组38例,门诊组74例)均进行乳腺查体、超声及X线检查,并作穿刺或手术取活检明确病理诊断.3种检查的结果与病理诊断对照,分别计算出各自的灵敏度、特异度、准确度、阳性预测值及κ值.结果 112例可疑乳腺癌病例中有61例乳腺癌,1例良性病变.乳腺临床查体、超声、X线检查的灵敏度分别为68.85%、88.52%、72.13%;特异度分别为88.23%、21.57%、56.86%;准确度分别为77.68%、58.04%、65.18%.三者两两联合后,乳腺超声与X线检查的灵敏度最高,为98.36%(P＜0.05),但特异度差,仅为3.92%(P＜0.05),准确度为55.36%,而临床查体与X线联合检查的灵敏度虽然较低,为85.25%,但特异度和准确度均较高,分别为56.86%和70.27%.结论 临床查体、乳腺超声、X线检查诊断乳腺癌各有特点.其中乳腺超声的灵敏度最高(P＜0.05),临床查体的特异度最好(P＜0.05),线检查对癌前病变及0期乳腺癌的检出率最高(P＜0.05).若三者联合使用,可以互相补充,减少漏诊,提高早期乳腺癌的检出率,满足大规模乳腺癌普查的需要.     

Diagnostic accuracy of Fischer Senoscan Digital Mammography versus screen-film mammography in a diagnostic mammography population

RATIONALE AND OBJECTIVES: To compare the diagnostic accuracy of the Fischer Senoscan Digital Mammography System with that of standard screen-film mammography in a population of women presenting for screening or diagnostic mammography. MATERIALS AND METHODS: Enrollment of patients took place at six different breast-imaging centers between 1997 and 1999. A total of 247 cases were selected for inclusion in the final reader study. All known cancer cases were included (111) from all six participating sites representing 45% of the total cases. The remaining 136 cases (55%) were randomly selected from all available benign or negative cases from three of the six sites. A complete case consisted of both a (unilateral or bilateral) digital and screen-film mammogram of the same patient. Eight radiologists interpreted the cases in laser-printed digital and screen-film hardcopy formats. The study was designed to detect differences of 0.05 in the ROC area under the curve (AUC) between digital and screen-film radiologist interpretation performance. RESULTS: The average AUC for the Senoscan digital was 0.715 for the 8 readers. The average AUC for screen-film was 0.765. The difference AUC of -0.05 falls within the 95% confidence interval (-0.101, 0.002). The average sensitivity was 66% and specificity 67% for SenoScan full-field digital mammography. The average screen-film mammography sensitivity and specificity were 74% and 60%, respectively. CONCLUSION: No statistically significant difference in diagnostic accuracy between the Fischer Senoscan and screen-film mammography was detected in this study.     

数字乳腺X线摄影:男性乳腺疾病诊断的推荐检查可行性分析

目的 基于敏感性、特异性等指标的评价,探讨数字乳腺X线摄影及超声对男性乳腺病变的诊断价值.方法 选取79例行乳腺X线摄影检查的男性乳腺肿块病例,部分病例同时行超声检查(62例).乳腺病灶评价依据2013版BI-RADS,通过2位高年资乳腺放射医师对征象进行分析后作出BI-RADS分类,并将BI-RADS 4a类以上定义...     

Diagnosis of breast cancer: contribution of US as an adjunct to mammography.

PURPOSE: To determine the value of ultrasonography (US) as an adjunct to mammography for the diagnosis of breast cancer. MATERIALS AND METHODS: In a 2-year prospective study, 4,811 mammograms were classified according to level of suspicion of malignancy. Targeted US was performed to analyze (a) circumscribed lesions, possibly cysts; (b) palpable lesions visible at mammography; (c) palpable lesions not visible at mammography; and (d) nonpalpable lesions visible at mammography. After US was performed in 1,103 cases (23%), cases were reclassified for level of suspicion. RESULTS: In 338 cases, breast cancer was diagnosed. The sensitivity of mammography for all 4,811 cases was 83%; the specificity was 97%. After US, the combined sensitivity increased to 91%, with a specificity of 98%. The increase was significant (P < .001). The increase in sensitivity was highest among women younger than 50 years. The positive predictive value for mammography was high (72%), which reflects a high threshold for biopsy; this may have augmented the yield of US. CONCLUSION: The use of US as an adjunct to mammography resulted in an increase in diagnostic accuracy. Its contribution to the diagnosis of breast cancer in this study was 7.4%.     

高频超声与全数字化乳腺摄影联合诊断乳腺导管癌的临床应用

目的:探讨乳腺导管癌的高频超声表现,并评价高频超声联合全数字化乳腺摄影检查对乳腺导管癌的诊断价值。方法:分析46例经病理证实的乳腺导管癌的超声表现,与相应病理结果进行对比分析。46例患者均行高频超声和全数字乳腺摄影检查。结果:高频超声探及到肿块46例,诊断乳腺癌45例,诊断率达98%。全数字化乳腺摄影诊断乳腺癌46例,诊断率达100%。高频超声和全数字化摄影对乳腺导管癌检出率无差别且无统计学意义(P>0.05)。结论:高频超声与全数字化乳腺摄影联合应用,可提高乳腺癌诊断的敏感性和准确性。     

Efficacy of storage phosphor-based digital mammography in diagnosis of breast cancer--comparison with film-screen mammography]

The aim of this study is to present efficacy of storage phosphor-based digital mammography (CR-mammography) in diagnosis of breast cancer. Ninety-seven cases with breast cancer including 44 cases less than 2 cm in macroscopic size (t1 cases) were evaluated using storage phosphor-based digital mammography (2000 x 2510 pixels by 10 bits). Abnormal findings on CR-mammography were detected in 86 cases (88.7%) of 97 women with breast cancer. Sensitivity of CR-mammography was 88.7%. It was superior to that of film-screen mammography. On t1 breast cancer cases, sensitivity on CR-mammography was 88.6%. False negative rate in t1 breast cancer cases was reduced by image processing using CR-mammography. To evaluate microcalcifications, CR-mammograms and film-screen mammograms were investigated in 22 cases of breast cancer proven pathologically the existence of microcalcifications and 11 paraffin tissue blocks of breast cancer. CR-mammography was superior to film-screen mammography in recognizing of microcalcifications. As regards the detectability for the number and the shape of microcalcifications, CR-mammography was equivalent to film-screen mammography. Receiver operating characteristic (ROC) analysis by eight observers was performed for CR-mammography and film-screen mammography with 54 breast cancer patients and 54 normal cases. The detectability of abnormal findings of breast cancer on CR-mammography (ROC area = 0.91) was better than that on film-screen mammography (ROC area = 0.88) (p less than 0.05). Efficacy of storage phosphor-based digital mammography in diagnosis of breast cancer was discussed and demonstrated in this study.     

X线摄影和螺旋CT诊断乳腺良恶性肿瘤的评价

目的：参照X线摄影在乳腺疾病诊断方面的特点．评价用螺旋CT扫描乳腺技术的诊断价值。方法：将外科手术证实的156例乳腺疾病患者分为乳腺癌组和非乳腺癌组．观察X线摄影和螺旋CT扫描对乳腺良恶性疾病诊断的准确性，并比较各自的优缺点。结果：156例有乳腺肿块的患者中．经手术和病理证实乳腺癌65例．乳腺良性疾病91例。65例乳腺癌中有10例乳腺X线摄影检查为阴性．其中4例因腺体致密而不能确诊。这4例中螺旋CT检出2例阳性病变。乳腺X线摄影诊断的敏感性和特异性分别为84．6％和83．5％．螺旋CT扫描为83．1％和76．9％。乳腺X线摄影和螺旋CT扫描的阳性预测值分别为78．6％和72．0％，其阴性预测值为88．4％和86．4％。结论：对于乳腺良恶性肿瘤的检查．首选乳腺X线。必要时CT可作为补充。     

Diagnostic accuracy of digital breast tomosynthesis versus digital mammography for benign and malignant lesions in breasts: a meta-analysis

Objective

To evaluate the diagnostic performance of digital breast tomosynthesis (DBT) and digital mammography (DM) for benign and malignant lesions in breasts.

Methods

Document retrieval was conducted on PubMed, EMBASE, the Cochrane Library, Web of Science and Chinese Biomedical Literature Database, etc., from 1950 to June 2013. Metadisc1.4 software was used to analyse the pooled sensitivity, specificity, diagnostic odds ratio (DOR), and positive and negative likelihood ratio. The heterogeneity was assessed using forest plots and the inconsistency index (I²). Before statistical comparison, the area under (AUC) the summary receiver-operating characteristic curve (SROC) of two different diagnostic methods was calculated respectively.

Results

A total of seven studies involving 2,014 patients and 2,666 breast lesions were included. Compared with the gold standard (histological results), the pooled sensitivity and specificity of DBT were 90.0 % and 79.0 %, and for DM they were 89.0 % and 72.0 %, respectively. The pooled positive likelihood ratio of DBT and DM was 3.50 and 2.83; the pooled negative likelihood ratio of DBT and DM was 15 % and 18 %; the pooled DOR for DBT and DM was 26.04 and 16.24, respectively.

Conclusions

Digital breast tomosynthesis has a higher sensitivity and specificity in breast diagnosis than digital mammography.

Key Points

? Digital breast tomosynthesis has high sensitivity and specificity in breast diagnosis. ? DBT appears to have superior diagnostic accuracy relative to digital mammography. ? DBT images were captured at a lower dose than 2D images. ? DBT displays abnormal features of lesions more clearly than DM. ? Digital breast tomosynthesis could become the first choice for assessing breast lesions.     

3.0T MRI成像技术与CR钼靶X线成像技术在乳腺癌诊断中的应用价值对照

目的:探讨3.0 T MRI与CR钼靶X线对乳腺癌诊断的价值。方法:收集46例乳腺病变患者,术前均行MRI、CR钼靶检查,均经手术病理证实。结果:46例患者中(57个病灶),乳腺癌30例(34个病灶),乳腺良性病变16例(23个病灶)。钼靶诊断乳腺癌的敏感度、特异度、准确度分别为70.59%,82.61%,75.44%;MRI诊断乳腺癌的敏感度、特异度、准确度分别为94.12%,78.26%,87.72%。结论:3.0 T MRI诊断乳腺癌的敏感度、准确度均高于CR钼靶检查,而特异度低于钼靶。