Lv Yongbin, Chi Xiaoxiao, Sun Bolin, Lin Shujuan, Xing Dong
From the Department of Radiology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong.
J Comput Assist Tomogr. 2020 May/Jun;44(3):405-412. doi: 10.1097/RCT.0000000000001019.
The aim of the study was to quantitatively analyze the enhancement of breast lesions by contrast-enhanced spectral mammography to improve the differential diagnosis ability of contrast-enhanced spectral mammography.
A total of 283 patients with breast lesions admitted from August 2017 to May 2018 were retrospectively analyzed. Quantitative analysis of all enhancing lesions was performed to measure the gray values of the lesion region of interest (ROI), the area close to the lesion (ROI1), the area close to the chest wall (ROI2), and the chest wall (ROI3). Differences in gray values between different ROIs of benign and malignant lesions were compared. Taking the pathological results as the criterion standard, we used the receiver operating characteristic curve to evaluate the diagnostic efficacy of the ROI gray value and relative gray value (rROI) for the lesions.
A total of 299 lesions were found in 283 patients, including 101 benign lesions and 198 malignant lesions. The ROI gray value, rROI1, rROI2, and rROI3 of malignant lesions were all significantly greater than those of benign lesions. The areas under the ROC curve of ROI, rROI1, rROI2, and rROI3 gray values of benign and malignant lesions were 0.795, 0.833, 0.812, and 0.741, respectively. The statistically significant difference in the area under the ROC curve was only found between rROI1 and ROI gray value and rROI1 had the greatest diagnostic value.
The gray value of malignant breast lesions was higher than that of benign lesions. The quantitative analysis of the gray value will help in the differential diagnosis of benign and malignant breast lesions.
本研究旨在通过对比增强光谱乳腺摄影对乳腺病变的强化进行定量分析，以提高对比增强光谱乳腺摄影的鉴别诊断能力。
回顾性分析2017年8月至2018年5月收治的283例乳腺病变患者。对所有强化病变进行定量分析，测量病变感兴趣区（ROI）、病变附近区域（ROI1）、胸壁附近区域（ROI2）和胸壁（ROI3）的灰度值。比较良性和恶性病变不同ROI之间的灰度值差异。以病理结果为标准，采用受试者工作特征曲线评估ROI灰度值和相对灰度值（rROI）对病变的诊断效能。
283例患者共发现299个病变，其中良性病变101个，恶性病变198个。恶性病变的ROI灰度值、rROI1、rROI2和rROI3均显著高于良性病变。良性和恶性病变的ROI、rROI1、rROI2和rROI3灰度值的ROC曲线下面积分别为0.795、0.833、0.812和0.741。仅在rROI1与ROI灰度值之间发现ROC曲线下面积有统计学显著差异，且rROI1具有最大诊断价值。
乳腺恶性病变的灰度值高于良性病变。灰度值的定量分析有助于乳腺良恶性病变的鉴别诊断。
