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断层扫描在检测乳腺肿块及鉴别良恶性病变中的价值。

Value of tomography in detecting breast masses and discriminating malign and benign lesions.

作者信息

Ata Korkmaz Hatice Ayça, Çakır Miraç İsmet, Bulut Eser, Kul Sibel

机构信息

Sağlık Bilimleri Üniversitesi, Kanuni Eğitim ve Araştırma Hastanesi, Radyoloji Kliniği, Trabzon, Türkiye.

Karadeniz Teknik Üniversitesi Tıp Fakültesi, Radyoloji Anabilim Dalı, Trabzon, Türkiye.

出版信息

Turk J Surg. 2019 Dec 16;35(4):265-272. doi: 10.5578/turkjsurg.4258. eCollection 2019 Dec.

Abstract

OBJECTIVES

The main purpose of the present study was to determine the effectivity of computerized tomography (CT) in detecting breast masses and discriminating masses as malignant or benign.

MATERIAL AND METHODS

After having received the institutional local ethics committee approval, an experienced radiologist who did not participate in the study created a patient pool by searching our health center's Pathology department database between 2010 and 2018. The group created consisted of dense and non-dense breast types equally and included approximately similar percentages of benign and malignant breast mass sizes. Finally, 70 subjects were included: 30 females with definite malign, 20 with definite benign breast masses, and 20 without any breast pathology based on mammography and ultrasonography results, who were considered as the control group. Three experienced Radiologists (R1, R2, R3) who were not aware of the final diagnosis evaluated all images independently. Radiologist performance was assessed by calculating the area under the receiver operating characteristic curve (AUC) and interobserver reliability values were estimated by intraclass correlation coefficient (ICC) analysis.

RESULTS

The diagnostic accuracy suitability of CT according to BI-RADS scores for R1, R2 and R3 were found as p <0.001, p <0.001 and p <0.001, respectively. There were significant interobserver reliability rates between all investigators (p= 0.0001).

CONCLUSION

CT may be used as a valuable diagnostic tool in discriminating breast masses with further training in widely varying appearances of normal breast tissues leading to false positive findings.

摘要

目的

本研究的主要目的是确定计算机断层扫描(CT)在检测乳腺肿块以及鉴别肿块为恶性或良性方面的有效性。

材料与方法

在获得机构当地伦理委员会批准后,一位未参与该研究的经验丰富的放射科医生通过检索我们健康中心病理科2010年至2018年的数据库创建了一个患者池。创建的组中致密型和非致密型乳腺类型数量相等,并且良性和恶性乳腺肿块大小的百分比大致相似。最后,纳入了70名受试者:30名确诊为恶性的女性,20名确诊为良性乳腺肿块的女性,以及20名根据乳房X线摄影和超声检查结果无任何乳腺病变的女性,后者被视为对照组。三名不了解最终诊断结果的经验丰富的放射科医生(R1、R2、R3)独立评估所有图像。通过计算受试者操作特征曲线(AUC)下的面积来评估放射科医生的表现,并通过组内相关系数(ICC)分析估计观察者间的可靠性值。

结果

R1、R2和R3根据BI-RADS评分得出的CT诊断准确性适用性分别为p<0.001、p<0.001和p<0.001。所有研究者之间的观察者间可靠性率均具有显著性(p = 0.0001)。

结论

CT可作为鉴别乳腺肿块的有价值的诊断工具,但需要针对正常乳腺组织广泛不同的表现进行进一步培训,以减少假阳性结果。

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