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[锥形束乳腺CT与乳腺钼靶对致密型乳腺恶性肿瘤诊断效能的比较]

[Comparison of the diagnostic efficiency in breast malignancy between cone beam breast CT and mammography in dense breast].

作者信息

Liu A D, Ma Y, Yin L, Han P, Li H J, Ye Z X

机构信息

Department of Radiology, Tianjin Medical University Cancer Institute and Hospital; National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin'Clinical Research Center for Cancer; Key Laboratory of Breast Cancer Prevention and Therapy; Tianjin Medical University, Ministry of Education, Tianjin 300060, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2018 Aug 23;40(8):604-609. doi: 10.3760/cma.j.issn.0253-3766.2018.08.008.

Abstract

To compare the diagnostic efficiency of lesion in dense breast between cone beam breast computer tomography (CBBCT) and mammography. From May 2012 to August 2014, 160 patients with 165 breasts who underwent mammography and CBBCT examinations were included in this study. The diagnostic results of CBBCT and mammography were reviewed and compared with pathological results. In the 165 breast, 24 were dense breasts and 141 were dense breasts. The diagnostic results were similar in 109 lesions, but different in 56 lesions. According to the analysis of the 165 breasts using receiver operation characteristics (ROC) curve, the area under the ROC curves (AUC) of CBBCT and mammography were 0.923 (95% 0.878-0.967, <0.05) and 0.959 (95% 0.926-0.992, <0.05), respectively. With Breast Imaging-Reporting and Data System (BI-RADS) 4b as the critical value, the sensitivity and specificity were 70.0% and 98.7% using mammography, and 83.3% and 97.3% using CBBCT, respectively. The AUC of CBBCT and mammography of the 141 dense breasts was 0.919(95% 0.868-0.969, <0.05) and 0.973(95% 0.947-0.999, <0.05), respectively. With BI-RADS 4b as the critical value, the sensitivity and specificity were 69.0% and 98.6% by mammography, and 83.1% and 98.6% by CBBCT, respectively. CBBCT showed higher sensitivity and specificity in the diagnosis of breast malignant tumors compared to mammography. It is expected to be applied to breast cancer detection in the future, especially in dense breast.

摘要

比较锥形束乳腺计算机断层扫描(CBBCT)和乳腺X线摄影对致密型乳腺病变的诊断效能。2012年5月至2014年8月,本研究纳入了160例患者的165侧乳房,这些患者均接受了乳腺X线摄影和CBBCT检查。回顾了CBBCT和乳腺X线摄影的诊断结果,并与病理结果进行比较。在这165侧乳房中,24侧为致密型乳腺,141侧为致密型乳腺。109个病变的诊断结果相似,但56个病变的诊断结果不同。根据对165侧乳房使用受试者操作特征(ROC)曲线分析,CBBCT和乳腺X线摄影的ROC曲线下面积(AUC)分别为0.923(95% 0.878 - 0.967,<0.05)和0.959(95% 0.926 - 0.992,<0.05)。以乳腺影像报告和数据系统(BI-RADS)4b为临界值,乳腺X线摄影的敏感性和特异性分别为70.0%和98.7%,CBBCT的敏感性和特异性分别为83.3%和97.3%。141侧致密型乳腺的CBBCT和乳腺X线摄影的AUC分别为0.919(95% 0.868 - 0.969,<0.05)和0.973(95% 0.947 - 0.999,<0.05)。以BI-RADS 4b为临界值,乳腺X线摄影的敏感性和特异性分别为69.0%和98.6%,CBBCT的敏感性和特异性分别为83.1%和98.6%。与乳腺X线摄影相比,CBBCT在乳腺恶性肿瘤诊断中显示出更高的敏感性和特异性。有望在未来应用于乳腺癌检测,尤其是在致密型乳腺中。

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