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中华消化病与影像杂志(电子版)

中华消化病与影像杂志(电子版) ›› 2022, Vol. 12 ›› Issue (03) : 138 -141. doi: 10.3877/cma.j.issn.2095-2015.2022.03.003

论著

数字乳腺断层摄影在乳腺良恶性结节鉴别中的价值
熊亮霞1, 方淇民1, 唐雪培1, 龚良庚1,†()   
  1. 1. 330006　南昌大学第二附属医院医学影像中心
  • 收稿日期:2021-08-05 出版日期:2022-06-01
  • 通信作者: 龚良庚
  • 基金资助:
    国家自然科学基金(81860316)

Value of digital breast tomosynthesis in distinguishing benign and malignant breast nodules

Liangxia Xiong1, Qimin Fang1, Xuepei Tang1, Lianggeng Gong1,†()   

  1. 1. Medical Imaging Center, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
  • Received:2021-08-05 Published:2022-06-01
  • Corresponding author: Lianggeng Gong
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引用本文：

熊亮霞, 方淇民, 唐雪培, 龚良庚. 数字乳腺断层摄影在乳腺良恶性结节鉴别中的价值[J]. 中华消化病与影像杂志(电子版), 2022, 12(03): 138-141.

Liangxia Xiong, Qimin Fang, Xuepei Tang, Lianggeng Gong. Value of digital breast tomosynthesis in distinguishing benign and malignant breast nodules[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2022, 12(03): 138-141.

目的

与乳腺超声检查结果对比，评估数字乳腺断层X线摄影(DBT)鉴别乳腺良、恶性结节的效能。

方法

回顾性分析2019年1月至2020年6月于南昌大学第二附属医院进行乳腺结节手术的患者资料，分别计算DBT及超声诊断乳腺良恶性结节的灵敏度、特异度及准确度，采用ROC分析评价DBT及超声结果与病理结果的一致性，并对二者进行比较。

结果

DBT与超声对乳腺良恶性结节诊断的灵敏度分别为88.46%、75.00%，特异度为91.43%、94.29%，准确度为91.95%、82.76%，AUC为89.0%、81.8%。DBT诊断乳腺结节的准确度、灵敏度及曲线下面积均高于超声检查，特异度略低于超声检查。

结论

DBT在乳腺结节良恶性的鉴别中具有较高的诊断效能，有利于乳腺癌的筛查及诊断，其效能不亚于乳腺超声。

关键词: 乳腺结节, 数字乳腺断层摄影, 乳腺超声
Objective

To evaluate the effectiveness of digital breast tomosynthesis (DBT) in the differential diagnosis of benign and malignant breast nodules by comparing with ultrasound.

Methods

The data of patients underwent breast nodule surgery in the Second Affiliated Hospital of Nanchang University from January 2019 to June 2020 were analyzed retrospectively. The sensitivity, specificity and accuracy of DBT and ultrasound in differential diagnosis of benign and malignant breast nodules were calculated. ROC analysis was used to evaluate the consistency of DBT and ultrasound results with pathological results, and the two were compared.

Results

The sensitivity, specificity, accuracy and AUC of DBT in the evaluation of benign and malignant breast lesions were 88.46%, 91.43%, 91.95%, 89.0%, respectively. While the corresponding results of breast ultrasound were 75.00%, 94.29%, 82.76%, 81.8%, respectively. The accuracy, sensitivity and AUC of DBT in the diagnosis of benign and malignant breast nodules were higher than those of ultrasound, but the specificity was slightly lower than that of ultrasound.

Conclusion

DBT is a more sensitive examination method for differentiating diagnosis of benign and malignant breast nodules, which is beneficial for breast cancer screening and diagnosis, and its efficiency is no less than that of breast ultrasound.

Key words: Breast nodule, Digital breast tomosynthesis, Ultrasound
图2 患者女性，57岁，DBT示左乳中央区下方见等腺体密度结节，边界清，BI-RADS分级为4A；超声示左侧乳腺约3点钟乳头旁腺体内可见一个低回声结节，大小约6.1 mm×5.5 mm×4.6 mm，边界欠清，形态欠规则，内部回声不均匀，未见点状钙化，后方回声无改变，CDFI于结节内未探及明显血流信号，BI-RADS分级为4A；最终病理为(左乳)导管内乳头状瘤
表1 两种方法对乳腺病灶的乳腺影像报告与数据系统评估结果(例)
诊断方法 乳腺影像报告与数据系统分类
0 1~3 4A 4B 4C 5
数字乳腺断层X线摄影 2 20 17 20 23 5
乳腺超声 5 26 18 13 16 9
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