全数字化X线摄影及术前定位在临床触诊阴性乳腺病变中的应用

The application value of full-field digital mammography and preoperative localization in nonpalpable breast lesions

目的：探讨全数字化乳腺摄影（FFDM）及术前定位技术对临床触诊阴性乳腺病变（NPBL）的诊断价值。方法：NPBL147例均在FFDM引导下行术前定位，术后病理检查。结果：147例中共151个乳腺病变，149个一次定位成功，2个二次定位成功，满意率98．6％。所有定位病灶中146例一次手术切除成功。恶性肿瘤40个，良性病变111个。FFDM及其定位系统对NPBL的诊断准确度、敏感度、特异度、阳性预测值和阴性预测值分别为72．2％、90．0％、65．8％、48．6％、94．8％。钙化的形态、分布、边缘及结节的形态、边缘、密度在鉴别良恶性NPBL中差异均有统计学意义（P〈0．05-P〈0．01）。结论：FFDM引导下术前定位技术对NPBL定位准确、创伤小，操作简单，能够指导临床准确切除病灶。

Objective：To evaluate the value of full-field digital mammography（FFDM） and preoperative localization in the diagosis of nonpalpable breast lesions （NPBL）. Methods： NPBL in 147 patients were located by FFDM, and confirmed by postoperative pathological results. Results：One hundred and fifty-one lesions were found in 147 patients, 149 and 2 lesions were successfully located at first time and the second, respectively. The satisfaction rate was 98.6%. One hundreed and forty-six lesions were successfully resected. Breast carcinoma in 40 lesions and benign tumor in 111 lesions were found. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of NPBL in FFDM and location were 72. 2%, 90. 0%, 65. 8%, 48. 6% and 94.8% ,respectively. The differences of shape ,distribution and border of calcification and shape, border and density of nodules in the diagnosis of benign and malignant tumor had statistical significance （P 〈 0.05 to P 〈 0.01 ）. Conclusions： The NPBL localization guided by FFDM is accurate,less trauma and simple ,which can guide the clinic.