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21.
Samira Saraya Lamia Adel Asmaa Mahmoud 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):547-552
Objective
To assess the efficiency of dual energy contrast enhanced mammography in the assessment of the indeterminate breast lesions (BIRADS 3 and BIRADS 4).Materials and methods
34 female having 39 indeterminate breast lesions (BIRADS 3 and BIRADS 4) by digital mammography were further examined by dual energy contrast enhanced mammography. Two images were acquired at low and high energy in MLO view after 2 min and in CC view at 4 min post iodinated contrast injection (1.5 ml/kg with flow of 4 ml/s). Images were processed to obtain subtracted images to enhance the areas of the contrast uptake.Results
Results from pathology were detected for all cases. Contrast enhanced digital mammography showed specificity, sensitivity, PPV, NPV, FDR, FPR and accuracy of 93.75%, 91.3%, 88.2%, 95.4%, 11.7%, 8.6% and 92.3% respectively compared to full field digital mammography which were 68.75%, 69.5%, 61.1%, 76.1%, 38.8%, 30% and 69.2% respectively.Conclusion
Contrast-enhanced digital mammography is a useful tool to be used for breast cancer detection especially in indeterminate lesions (BIRADS 3 and 4). 相似文献22.
Christoph I. Lee MD MSHS Colin J. Wells MD Lawrence W. Bassett MD 《The breast journal》2013,19(1):41-48
The objective of this study was to compare direct health care costs for two competing diagnostic strategies for probably benign breast lesions detected by ultrasound in young women. We developed a decision analytic model and performed a cost minimization analysis comparing ultrasound‐guided vacuum‐assisted core biopsy and conservative short‐term diagnostic ultrasound follow‐up. Relative probabilities for diagnostic outcomes were derived from pooled analysis of the medical literature. Direct health care costs were estimated using United States national average figures from calendar year 2010. Deterministic sensitivity analyses were conducted, as well as a first‐order Monte Carlo simulation to confirm cost differences between the two strategies. The conservative short‐term imaging follow‐up strategy ($639.55 average cost per patient) was the most economical strategy compared to immediate vacuum‐assisted core biopsy ($879.55 average cost per patient). Sensitivity analyses demonstrated that the preferred strategy is most dependent on the probabilities of detecting change in appearance on follow‐up ultrasound, having a benign finding on immediate core biopsy, and finding cancer on a biopsy triggered by an interval change in ultrasound appearance. The model was also sensitive to the costs of vacuum‐assisted core biopsy and diagnostic ultrasound. Conservative imaging follow‐up of BIRADS 3 breast masses by ultrasound is cost saving compared to immediate vacuum‐assisted core biopsy, with a potential of saving more than one‐third of overall costs associated with the diagnostic work‐up of such lesions. Watchful waiting with short‐term interval follow‐up ultrasounds will spare women from unnecessary procedures and spare the United States health care system from unnecessary direct health care costs. 相似文献