乳腺断层摄影合成技术的临床价值

目的:探讨数字乳腺断层合成X线成像(DBT)结合合成2D图像(SM)对乳腺微钙化的检出和诊断效能。方法:回顾性分析228例乳腺影像及病理资料。3名影像医师独立阅读DBT结合全视野数字化乳腺摄影(FFDM)、DBT结合SM、FFDM、SM 4种模式下影像资料,记录微钙化有无,根据BI-RADS 2013版对微钙化进行分类,分析不同密度乳腺类型中良、恶性微钙化的检出率及诊断效能。结果:不管在致密型乳腺或所有腺体类型乳腺中,4种阅片模式对微钙化检出敏感度的差异无统计学意义(P>0.05),特异度均为100%。DBT结合SM与DBT结合FFDM对微钙化诊断敏感度、特异度及ROC曲线下面积的差异无统计学意义(P>0.05);FFDM的敏感度高于SM,特异度低于SM,ROC曲线下面积高于SM,差异均具有统计学意义(P<0.05)。结论:DBT结合SM与DBT结合FFDM对乳腺微钙化的检出、诊断效能相似。

Clinical value of synthesis technique for mammography

Abstract: Objective To investigate the detection rate of digital breast tomosynthesis (DBT) combined with synthetic 2D mammography (SM) for microcalcifications and to disscuss the diagnostic efficiency. Methods The breast imaging and pathological data of 228 cases were analyzed retrospectively. Three radiologists independently interpreted the imaging data in 4 different reading modes, including DBT combined with full-field digital mammography (FFDM), DBT combined with SM, FFDM, and SM, and recorded the presence of microcalcifications or not. Finally, the microcalcifications was classified according to BI-RADS 2013. The detection rates of benign and malignant microcalcifications in different mammary glands and the diagnostic performances were analyzed. Results For either dense mammary gland or all types of mammary glands, there was no significant difference in the detection sensitivity of different reading modes to microcalcifications (P>0.05), and the specificity was 100%. No significant difference was found in diagnostic sensitivity, specificity and the area under ROC curve between DBT combined with SM and DBT combined with FFDM (P>0.05). The diagnostic sensitivity and the area under ROC curve of FFDM were higher than those of SM, but the specificity was lower than SM (all P<0.05). Conclusion DBT combined with SM and DBT combined with FFDM have similar performances in microcalcifications detection and diagnostic efficiency.