Ding Jian-hui, Peng Wei-jun, Jiang Zhao-xia, Xu Lin-hui, Hu Dan-ting, Zheng Xiao-jing
Department of Diagnostic Radiology, Fudan University, Shanghai 200032, China.
Zhonghua Zhong Liu Za Zhi. 2009 Nov;31(11):854-7.
To evaluate the diagnostic value of full-field digital mammography for breast cancer.
The clinical data and mammograms of 230 patients with breast diseases between January 2008 and July 2008 were collected and reviewed. Craniocaudal (CC) and mediolateral oblique (MLO) view mammograms were performed in all patients before surgery. Three experienced radiologists in breast imaging assessment analyzed and classified all the mammograms according to breast imaging reporting and data system (BI-RADS). The sensitivity, specificity and accuracy were evaluated according to their pathological diagnosis. The reasons resulting in false-negative and false-positive diagnosis were also analyzed.
Of the 238 samples, 130 had a malignant breast tumors and 108 cases of benign breast lesions. One hundred and nine of the 130 malignant breast tumors were invasive ductal carcinoma. Fifty-seven of the 108 benign breast lesions were breast adenosis. Masses or masses with microcalcification were the most frequently seen signs of the malignant tumors, accounting for 40.8% and 20.8%, respectively. The sensitivity, specificity and accuracy of FFDM in detecting breast carcinoma were 90.8%, 87.0% and 89.1%, respectively. The false-negative signs including negative X-ray finding (5 cases) and focal asymmetric densities (4 cases). The false-positive signs were masses with spiculate, indistinctive or lobulated margin leading to misdiagnosing the lesions as malignant tumors.
Full-field digital mammography (FFDM) is helpful in detection of breast cancers in women, with a higher sensitivity, specificity and accuracy, and has an important clinical application value.
评估全视野数字化乳腺摄影对乳腺癌的诊断价值。
收集并回顾2008年1月至2008年7月期间230例乳腺疾病患者的临床资料及乳腺X线片。所有患者在手术前行头尾位(CC)和内外斜位(MLO)乳腺X线摄影。三位经验丰富的乳腺影像评估放射科医生根据乳腺影像报告和数据系统(BI-RADS)对所有乳腺X线片进行分析和分类。根据病理诊断评估其敏感性、特异性和准确性。同时分析导致假阴性和假阳性诊断的原因。
238份样本中,乳腺恶性肿瘤130例,乳腺良性病变108例。130例乳腺恶性肿瘤中109例为浸润性导管癌。108例乳腺良性病变中57例为乳腺腺病。肿块或伴有微钙化的肿块是恶性肿瘤最常见的征象,分别占40.8%和20.8%。全视野数字化乳腺摄影检测乳腺癌的敏感性、特异性和准确性分别为90.8%、87.0%和89.1%。假阴性征象包括X线表现阴性(5例)和局灶性不对称致密影(4例)。假阳性征象为边缘有毛刺、不清晰或分叶状的肿块,导致将病变误诊为恶性肿瘤。
全视野数字化乳腺摄影(FFDM)有助于女性乳腺癌的检测,具有较高的敏感性、特异性和准确性,具有重要的临床应用价值。