以标本排水法为金标准比较不同方法测量乳房体积准确性的前瞻性研究

The accuracy of four methods of breast volume measurement compared with specimen volume: a prospective study

目的以排水法测量全乳房切除标本结果为乳房体积金标准,探讨线性测量法、间接测量法、CT测量法及MRI测量法与金标准的一致性,为提高乳房重建率提供临床思路。方法以2020年1月至2021年2月于北京大学第一医院行乳房单纯切除术的女性乳腺癌患者为研究对象,在术前收集线性测量法、间接测量法、CT测量法及MRI测量法得到的乳房体积数据,以排水法测量全乳房切除标本体积作为金标准。利用相关性分析、线性回归和Bland-Altman分析分别对4种测量方法与金标准的相关性进行检验分析。结果研究共入组47例患者(49侧乳房),线性测量法、间接测量法、CT测量法和MRI测量法的相关系数r值分别为0.625、0.916、0.994、0.995(P<0.001),线性回归系数R2分别为0.378、0.835、0.982、0.989(P<0.001),4种方法与金标准均显著相关。Bland-Altman分析提示4种方法与标本排水法显著相关。结论线性法、间接法、CT法及MRI法测量乳房体积与标本排水法测量结果显著相关,MRI法的准确性最好,CT法亦有较高的临床应用价值。

ObjectiveTo prospectively compare the accuracy of four different methods(anthropometric,indirect,CT and MRI),with the mastectomy specimen volume as the gold standard,and provide clinical ideas to increase the rate of immediate breast reconstruction.MethodsThe patients who were diagnosed with breast cancer and received mastectomy at Peking University First Hospital between January 2020 and February 2021 entered the prospective study.Breast volumes were measured preoperatively by four different methods(anthropometric,indirect,CT and MRI).Specimen volume after mastectomy was measured with the water displacement method(the gold standard)in the operation room.The results were analyzed by correlation analysis.Linear regression and Bland-Altman analysis were also used to evaluate the consistency of the four methods and the gold standard respectively.ResultsA total of 47 patients(49 breasts)were enrolled in the prospective study.The correlation coefficientsrof anthropometric,indirect,CT and MRI measurement methods were 0.625,0.916,0.994 and 0.995(P<0.001),respectively;the linear regression coefficientsR2were 0.378,0.835,0.982 and 0.989(P<0.001),respectively.The Bland-Altman analysis also indicated that the four methods were significantly correlated with the gold standard.ConclusionThe measurements of breast volume by four methods including anthropometric,indirect,CT and MRI are significantly correlated with the specimen volume.The accuracy of MRI is the best while CT has a higher clinical application value.