仅在数字乳腺断层合成摄影中可见、超声下隐匿性结构扭曲（AD）的病理结果，并与在 2D 乳腺摄影中也可见 AD 的结果进行比较。
Pathological outcome of sonographically occult architectural distortions (AD) visible only on digital breast tomosynthesis, and comparison with AD visible also on 2D mammography.
机构信息
Institute of Radiology, University Hospital S.Maria della Misericordia, p.le S.Maria della Misericordia n.15 - 33100, Udine, Italy.
Institute of Radiology, University Hospital S.Maria della Misericordia, p.le S.Maria della Misericordia n.15 - 33100, Udine, Italy.
出版信息
Eur J Radiol. 2022 Jan;146:110075. doi: 10.1016/j.ejrad.2021.110075. Epub 2021 Nov 26.
PURPOSE
To evaluate the rates of malignant and of high-risk lesions among sonographically occult architectural distortions (AD) visible only on digital breast tomosynthesis (DBT) and compare them with AD visible on 2D mammography (2D) and DBT.
METHOD
The records of 1104 DBT-vacuum assisted biopsies (DBT-VAB) were retrospectively reviewed and 218 cases of AD were identified. Complete radiologic examinations and pathologic results were available for 113 sonographically occult AD (1 clinically-detected, 112 clinically-occult). 2D and DBT images were reviewed and AD were divided into a "DBT-detected" group (visible on only DBT) and a "2D-detected" group (visible both in 2D and DBT). The rates of malignant and of high-risk lesions in the "DBT-detected" AD group were calculated and compared to those of the "2D-detected" AD group.
RESULTS
Thirty-five (31%) of 113 AD were assessed as "DBT-detected", while 78 (69%) as "2D-detected". DBT-VAB results were benign lesions in 63 (56%) AD, high-risk lesions in 32 (28%) AD and malignant lesions in 18 (16%) AD. Four (12.5%) high-risk lesions were upgraded to malignancy at surgery. Based on final pathology, the malignancy rate was significantly higher in the "DBT-detected" group than the "2D-detected" group (34% [12/35 cases] vs 13% [10/78]; p < 0.05). The high-risk lesion rates were 32% (11/35 cases) in the "DBT-detected" group and 22% (17/78 cases) in the "2D-detected" group (p > 0.05).
CONCLUSIONS
AD visible on only DBT proved to be malignant in about one third of cases, which exceeded the malignancy rate of AD visible on also 2D. A similar proportion of DBT-only AD was represented by high-risk lesions.
目的
评估仅在数字乳腺断层摄影术（DBT）上可见的超声隐匿性结构扭曲（AD）的恶性和高危病变发生率，并与在二维（2D）乳腺摄影术（2D）和 DBT 上可见的 AD 进行比较。
方法
回顾性分析了 1104 例 DBT 真空辅助活检（DBT-VAB）的记录，发现 218 例 AD。113 例超声隐匿性 AD （1 例临床发现，112 例临床隐匿性）均获得完整的影像学检查和病理结果。对 2D 和 DBT 图像进行了回顾，将 AD 分为“DBT 检出”组（仅在 DBT 上可见）和“2D 检出”组（在 2D 和 DBT 上均可见）。计算了“DBT 检出”AD 组的恶性和高危病变发生率，并与“2D 检出”AD 组进行了比较。
结果
113 例 AD 中有 35 例（31%）被评估为“DBT 检出”，78 例（69%）为“2D 检出”。DBT-VAB 结果为良性病变 63 例（56%），高危病变 32 例（28%），恶性病变 18 例（16%）。4 例（12.5%）高危病变在手术中升级为恶性肿瘤。根据最终病理，“DBT 检出”组的恶性率明显高于“2D 检出”组（34%[12/35 例]比 13%[10/78 例]；p<0.05）。“DBT 检出”组高危病变率为 32%（11/35 例），“2D 检出”组高危病变率为 22%（17/78 例）（p>0.05）。
结论
仅在 DBT 上可见的 AD 有近三分之一被证实为恶性，高于在 2D 上也可见的 AD 的恶性率。在 DBT 上仅有的 AD 中，高危病变的比例也相似。
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