目的探讨数字乳腺断层摄影(DBT)对致密型乳腺内结构扭曲病变的诊断价值。资料与方法回顾性分析经DBT及全数字化乳腺 X线摄影(FFDM)检查发现乳腺结构扭曲,并经病理证实的 59例患者,以病理结果为"金标准",比较FFDM及 FFDM+DBT图像对乳腺结构扭曲病变的诊断价值。结果对于致密型乳腺,FFDM+DBT对乳腺结构扭曲病变的总体检出率(100.0%)高于 FFDM(84.7%),FFDM+DBT及 FFDM诊断乳腺结构扭曲的敏感度、特异度及准确率分别为89.7%(35/39)比 66.7%(26/39)、55.0%(11/20)比 45.0%(9/20)、78.0%(46/59)比 59.3%(35/59),FFDM+DBT较 FFDM的诊断敏感度及准确率高,差异有统计学意义(χ^2=6.09、4.76,P<0.05)。两种检查的诊断特异度差异无统计学意义(χ^2=0.40,P>0.05)。FFDM+DBT诊断结构扭曲的阳性预测值及阴性预测值分别为 79.5%(35/44)、73.3%(11/15),高于 FFDM诊断的70.3%(26/37)、40.9%(9/22)。结论 FFDM+DBT比 FFDM对致密型乳腺结构扭曲病变的总体检出率有显著提高,且对病灶显示更加清晰,诊断准确率提高,具有较大的临床应用价值。
Purpose To explore digital breast tomosynthesis (DBT) in the diagnosis of dense breast internal structure distortion. Materials and Methods A retrospective analysis was performed on 59 patients with breast structure distortion detected by DBT and full-field digital mammography (FFDM) and confirmed by pathology. The pathological results were taken as the "gold standard", and the value between FFDM alone and FFDM combined with DBT in the diagnosis of breast structure distortion were compared. Results The overall detection rate of FFDM combined DBT (100.0%) was higher than that of FFDM alone (84.7%) in respect of dense breast, and the sensitivity, specificity and accuracy between FFDM combined with DBT and FFDM alone in the diagnosis of breast structure distortion was 89.7%(35/39) vs. 66.7%(26/39), 55.0%(11/20) vs. 45.0%(9/20) and 78.0%(46/59) vs. 59.3%(35/59), respectively. Moreover, the diagnostic sensitivity and accuracy of FFDM combined with DBT were higher than that of FFDM alone, and the difference was statistically significant (χ^2 =6.09, 4.76, P<0.05). However, the difference between them in respect of specificity was not statistically significant (χ^2 =0.40, P>0.05). Furthermore, the positive predictive value and negative predictive value of FFDM combined with DBT in the diagnosis of structure distortion were 79.5%(35/44) and 73.3%(11/15), respectively, which were higher than that of FFEM alone [70.3%(26/37) and 40.9%(9/22)]. Conclusion The FFDM combined with DBT could not only significantly improve the overall detection rate of dense breast structural distortion, but also could bring a more clear lesion display and increased diagnostic accuracy, so it was of great clinical application value.
Chinese Journal of Medical Imaging