数字乳腺断层合成摄影和全视野数字化乳腺摄影在乳房肿块型病变中的诊断价值

目的 探讨数字乳腺断层合成摄影技术(DBT)和全视野数字化乳腺摄影(FFDM)及DBT联合FFDM在乳房肿块型病变中的诊断价值.方法 收集2018年5月至2019年8月在安徽医科大学附属安庆医院就诊的乳房肿块型疾病病人101例,分别使用FFDM、DBT及DBT+FFDM进行独立诊断,以病理结果为金标准,参照2013版BI-RADS标准对病灶进行分类、评估,采用受试者工作特征(ROC)曲线对FFDM、DBT及DBT+FFDM三种检查方法的诊断效能进行比较.结果 101例病人中发现54例良性病灶和47例恶性病灶.FFDM、DBT及DBT+FFDM的ROC曲线下面积(AUC)分别为(0.719±0.045)、(0.942±0.023)、(0.963±0.018),DBT或DBT+FFDM的AUC均高于FFDM,差异有统计学意义(P<0.05).在乳腺密度不均匀致密型、极度致密型、年龄小于50岁及绝经前的病人中,DBT或DBT+FFDM的AUC均高于单独FFDM,差异有统计学意义(P<0.05).结论DBT或DBT联合FFDM与单独FFDM相比在一定程度上提高了诊断乳房良、恶性肿块型病变的准确性,增加了诊断的灵敏度和特异度.

Applied study on the diagnostic value of digital breast tomosynthesis and full-field digital mammography in breast mass-like lesions

Objective To explore the diagnostic value of digital breast tomography(DBT),full-field digital mammographyg (FFDM) and DBT combined with FFDM in breast mass-like lesions.Methods To collect 101 patients with breast mass-like lesions admitted to Anqing Hospital affiliated to Anhui Medical University from May 2018 to August 2019 ,using DBT,FFDM and DBT combined FFDM todiagnosis breast mass-like lesions independently .The pathological results were taken as the gold standard. The lesions were classifiedand evaluated according to the version of BI-RADS in 2013,Receiver operating characteristic (ROC) curve was used to compare the diagnostic efficacy of FFDM,DBT and DBT+FFDM in breast mass-like lesions.Results There were 54 benign lesions and 47 malignantlesions in 101 patients.The AUC of FFDM,DBT and DBT+FFDM were (0.719±0.045),(0.942±0.023),(0.963±0.0180) respectively,the results showed that the AUC of DBT or DBT+FFDM was higher than FFDM alone, with significant difference (P< 0.05).In breast density ACR c-d,age < 50 years and premenopausal patients ,the AUC of DBT or DBT+FFDM was both higher than that of FFDM alone,withsignificant difference(P < 0.05).Conclusion Compared with FFDM alone, DBT or DBT combined with FFDM can improve the accuracy of diagnosis of benign and malignant breast mass lesions, and increase the sensitivity and specificity of diagnosis.