数字乳腺融合断层技术在乳腺癌诊断中的应用价值

发布时间：2018-01-20 09:28

本文关键词： 数字乳腺断层摄影全数字乳腺摄影乳腺癌　出处：《第三军医大学学报》2015年23期 　论文类型：期刊论文

【摘要】：目的探讨数字乳腺融合断层(digital breast tomosynthesis,DBT)技术在乳腺癌诊断中的应用价值。方法收集759例来院做乳腺X线检查的患者,分别采用全数字乳腺X线摄影(full-field digital mammography,FFDM)和DBT摄影,并独立诊断,以病理诊断作为金标准,比较FFDM、FFDM结合DBT诊断乳腺癌的能力。结果 759例患者中,正常和良性病变555例,恶性病变204例。FFDM与FFDM结合DBT检查诊断乳腺疾病的差异有统计学意义(Z=-6.594,P0.000 1),两者对于乳腺癌的诊断差异有统计学意义(Z=-8.082,P0.000 1)。以病理诊断作为金标准,FFDM诊断乳腺癌的灵敏度67.6%,特异度96.2%,Youden指数0.638,阳性预测值86.8%,阴性预测值89%;FFDM结合DBT诊断乳腺癌的灵敏度80.9%,特异度97.1%,Youden指数0.78,阳性预测值91.2%,阴性预测值93.3%。FFDM诊断乳腺癌的ROC曲线下面积(the area under the curve,AUC)为0.899,FFDM结合DBT诊断乳腺癌的AUC值为0.969。FFDM结合DBT和FFDM的AUC差异有统计学意义(Z=7.126,P0.001)。DBT的辐射剂量高于FFDM,两者差异有统计学意义(CC位:Z=-27.005,P0.000 1;MLO位:Z=-27.514,P0.000 1)。结论 FFDM结合DBT诊断乳腺癌的能力高于FFDM,然而辐射剂量也高于FFDM,所以DBT不适于乳腺普查,更适用于对可疑病灶的鉴别诊断。
[Abstract]:Objective to investigate digital breast tomosynthesis of digital breast fusion tomography. The value of DBT technique in the diagnosis of breast cancer methods 759 patients who came to our hospital for mammography were collected. Full-field digital mammography (FFDM) and DBT were used for diagnosis. Using pathological diagnosis as gold standard, the ability of FFDM combined with DBT in the diagnosis of breast cancer was compared. Results among 759 patients, 555 were normal and 555 benign lesions. There were significant differences between FFDM and FFDM combined with DBT in the diagnosis of breast diseases in 204 cases of malignant lesions (P 0.000 1). There was significant difference between the two groups in the diagnosis of breast cancer. The sensitivity of FFDM in diagnosis of breast cancer was 67.6% with pathological diagnosis as the golden standard. The specificity was 96.2and the Youden index was 0.638, the positive predictive value was 86.8 and the negative predictive value was 89. The sensitivity of FFDM combined with DBT in the diagnosis of breast cancer was 80.9.The specificity was 97.1Youden index 0.78, and the positive predictive value was 91.2%. The area under the ROC curve of the area under the was 0.899. The AUC value of FFDM combined with DBT in the diagnosis of breast cancer was 0.969.The AUC value of DBT combined with FFDM was significantly different from that of FFDM 7.126. The radiation dose of P0.001U. DBT was higher than that of FFDM, and the difference between them was statistically significant. Conclusion the ability of FFDM combined with DBT to diagnose breast cancer is higher than that of FFDM, but the radiation dose is also higher than that of FFDM. Therefore, DBT is not suitable for mammary gland screening and is more suitable for differential diagnosis of suspected lesions.
【作者单位】：重庆医科大学附属第一医院放射科;
【基金】：国家临床重点专科建设项目基金(国卫办[2013]544号) 重庆市卫生局科研基金(2013-2-003)~~
【分类号】：R730.44;R737.9
【正文快照】： 数字乳腺融合断层(digital breast tomosynthesis,DBT)技术在欧美国家已运用于临床。DBT是由一系列从多角度拍摄所获摄得的低剂量X线图像经重建后合成的断层图像,能够让隐藏在重叠组织中的病灶显示更充分,在乳腺疾病的检出及诊断中发挥重要的作用,显著提高乳腺癌的早期诊断水

【参考文献】