全数字化乳腺摄影及其定位技术对触诊阴性乳腺病灶的应用探讨

Application of full-field digital mammography and its preoperative localization in patients with non-palpable breast lesions

目的：探讨全数字化乳腺摄影（FFDM）及其定位技术对触诊阴性乳腺病灶的应用价值。方法：从2003年4月-2008年10月对门诊及体检者行FFDM的20 000余例中遇到的乳腺病变建立病理结果与影像表现数据库,得到257例触诊阴性乳腺病灶。全部病例采用平板2000 D FFDM机检查,体位常规采用头尾位、侧斜位,必要时加摄侧位及局部点片。257例临床未触及包块的乳腺病灶均行术前定位。结果：（1）良性病变179例,恶性病变78例。（2）179例良性病灶中,单纯钙化占68.16%;78例恶性病灶中,单纯钙化占57.69%,且其中以簇状钙化占比最高,为66.67%。（3）FFDM对触诊阴性乳腺癌诊断的敏感性、特异性和准确性分别为88.46%、79.89%和82.49%。结论：FFDM及其术前定位技术对触诊阴性乳腺病灶的检出及指导外科手术具有重要价值。

Objective To evaluate the role of full-field digital mammography（FFDM） and its preoperative localization in the treatment of nonpalpable breast lesions（NPBL）.Methods 257 cases with NPBL were found in 20,000 patients undergoing FFDM during April 2003October 2008 and all the cases were pathologically confirmed.Crania caudal（CC） view and media lateral oblique（MLO） view were performed for every patient,and media lateral view or spot view was also performed if necessary.Preoperative localization was conducted for every patient.Results The pathological and mammographic findings showed that there were 179 benign lesions and 78 malignant lesions,and that the calcification was 68.16%（122/179）in benign lesions and 57.69%（45/78） in malignant lesions,the clustered calcification being the highest（66.67%）.The specificity,sensitivity and accuracy of FFDM for patients with non-palpable breast cancers were 88.46%,79.89%,and 82.49%,respectively.Conclusion Full-field digital mammography and preoperativelocalization have great value in detecting lesions and guiding surgery in patients with NPBL.