自动乳腺全容积扫描正交三切面观察乳腺肿瘤边缘征象的应用价值

目的分析自动乳腺全容积扫描（automated breast volume scanner,ABVS）正交三切面观察乳腺肿瘤边缘征象的应用价值。 方法回顾性分析2017年4月至2019年5月于陕西省肿瘤医院行乳腺外科手术并经术后病理证实的女性乳腺肿瘤患者206例共计292个病灶。所有患者术前均行ABVS检查,比较ABVS正交3个不同切面病灶边缘征象对乳腺良恶性肿瘤的诊断效能,并对正交三切面评价乳腺良恶性肿瘤的总体诊断效能进行分析。 结果292个病灶中,良性148个,恶性144个。以外科术后病理结果为"金标准",冠状面毛刺征诊断乳腺癌的敏感度为68.05%,与横切面的17.36%和矢状面的13.19%相比,差异均有统计学意义（χ²=5.63、41.19,P均<0.05）。冠状面边缘成角诊断乳腺癌的敏感度为42.36%,与横切面的26.38%和矢状面的22.22%相比,差异均有统计学意义（χ²=16.00、21.73,P均<0.001）。ABVS正交3个切面的病灶微小分叶和边缘模糊征象诊断乳腺癌的敏感度比较,差异均无统计学意义（P均>0.05）。ABVS正交三切面边缘微小分叶、毛刺征、边缘成角和边缘模糊诊断乳腺癌的敏感度、特异度、阳性预测值、阴性预测值和准确性分别为81.94%、86.48%、85.50%、83.11%、84.24%;68.75%、96.62%、95.19%、76.06%、82.87%;47.22%、95.27%、91.89%、64.97%、71.57%;54.16%、57.43%、55.31%、56.29%、55.82%。 结论ABVS冠状面毛刺征和边缘成角评价乳腺良恶性肿瘤具有优势,诊断敏感度优于矢状面与横切面。与其他边缘征象相比,微小分叶的综合评价效能具有稳定性,是诊断恶性结节敏感度和准确性最佳的表面特征。

Value of automatic breast volume scanning system in observing peripheral signs of breast tumors

ObjectiveTo assess the diagnostic value of automated breast volume scanning (ABVS) in comparing and observing the peripheral signs of breast tumors on three orthogonal sections. MethodsA retrospective analysis was performed on 206 women with 292 breast tumors who underwent breast surgery and postoperative pathological diagnosis at Shanxi Provincial Cancer Hospital from April 2017 to May 2019. ABVS was performed in all patients before operation to compare the diagnostic efficacy of ABVS on three different orthogonal sections for breast benign and malignant tumors, and to analyze the overall diagnostic efficacy of ABVS on three orthogonal sections for breast benign and malignant tumors. ResultsOf the 292 lesions, 148 were benign and 144 were malignant. Using the postoperative pathological results as the "gold standard", the sensitivity of coronal burr sign (68.05%) was significantly higher than that of transverse (17.36%) and sagittal (13.19%) sign (P<0.05). The sensitivity of coronal edge angulation (42.36%) was also significantly higher than that of transverse (26.38%) and sagittal (22.22%) edge angulation (P<0.001).There was no significant difference in the sensitivity of lobular and marginal fuzzy signs for the diagnosis of breast cancer (P>0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of edge microlobulation, burr, edge angulation, and edge blur on ABVS were 81.94%, 86.48%, 85.50%, 83.11%, and 84.24%), 68.75%, 96.62%, 95.19%, 76.06%, and 82.87%, 47.22%, 95.27%, 91.89%, 64.97%, and 71.57%, and 54.16%, 57.43%, 55.31%, 56.29%, and 55.82%, respectively. ConclusionCoronal burr sign and marginal angulation on ABVS are superior to those on sagittal and transverse sections in the evaluation of benign and malignant breast tumors with regard to diagnostic sensitivity. Compared with other peripheral features, micro-lobulation is the most sensitive and accurate surface feature for the diagnosis of malignant nodules.