全数字化乳腺X线摄影与超声萤火虫技术对乳腺微钙化检出的比较

目的评价超声"萤火虫"技术与全数字化乳腺X线（FFDM）相比在乳腺微钙化检出方面的意义及其临床应用价值。 方法收集山西医科大学第一医院于2016年11月至2017年11月经手术病理证实的乳腺病变患者126例,将其分为肿块伴钙化组、单纯钙化组、无钙化组（单纯肿块、非肿块无钙化）,所有患者于术前均行FFDM及超声"萤火虫"技术检查,比较超声"萤火虫"技术与FFDM对乳腺微钙化的显示情况,并以病理结果为金标准,采用受试者工作特征（ROC）曲线评价2种影像学方法对乳腺微钙化检出的效能,同时采用Z检验比较2种影像学方法的曲线下面积,评价其诊断价值。 结果（1）超声"萤火虫"成像显示肿块内微钙化的特异度（83%）较FFDM（91%）低,灵敏度（96%）较FFDM（91%）高,2者的ROC曲线下面积分别为0.894、0.909,但2者对肿块内微钙化的诊断价值差异无统计学意义（Z=0.25,P>0.05）。（2）超声"萤火虫"成像显示单纯微钙化的特异度、灵敏度（25%、79%）均较FFDM（87%、91%）低,2者的ROC曲线下面积分别为0.522、0.893,FFDM对单纯微钙化的诊断价值优于超声"萤火虫"成像技术（Z=3.71,P<0.05）。 结论超声"萤火虫"成像技术对乳腺微钙化检出的特异性不如FFDM,但其对乳腺肿块内微钙化检出的敏感性高,有助于超声科医师判断乳腺病变的良恶性。

Comparison of mammography and MicroPure imaging in detecting breast microcalcification

ObjectiveTo evaluate the significance and clinical application of MicroPure imaging in the detection of breast microcalcification by comparing with full-field digital mammography (FFDM). MethodsWe selected 126 breast lesions confirmed by surgical pathology at the First Hospital of Shanxi Medical University from November 2016 to November 2017. The lesions were divided into a tumor with calcification group, a simple calcification group, and a no calcification group (simple lumps and non-lumps without calcification). All patients underwent FFDM and MicroPure imaging before surgery, and the accuracy of detection of breast microcalcification by FFDM and MicroPure was compared. Using pathological results as the gold standard, ROC curve was plotted to evaluate the efficiency of the two imaging methods in detecting breast microcalcification. The Z test was used to compare whether the areas under the curves of the two imaging methods had a difference. ResultsThe specificity of MicroPure in detecting microcalcification in the mass was lower than that of FFDM (83% vs 91%), while the sensitivity was higher than that of FFDM (96% vs 91%). The areas under the ROC curves were 0.894 and 0.909, respectively, and they had equivalent diagnostic value for microcalcification in the mass (Z=0.25, P>0.05). The specificity and sensitivity of MicroPure imaging in detecting simple microcalcification were lower than those of FFDM (25% vs 87%; 79% vs 91%), and the areas under the ROC curves were 0.522 and 0.893, respectively, which suggested that FFDM had better diagnostic value compared with Micropure imaging for simple microcalcification (Z=3.71, P<0.05). ConclusionMicroPure imaging has a low specificity than FFDM in detecting breast microcalcification, but it has a high sensitivity in detecting microcalcification in breast masses, which is helpful for ultrasound doctors to distinguish benign and malignant breast lesions.