数字化乳腺X线引导下导丝定位钙化及切除活检患者的影像学表现与病理的相关性

Digital mammography-guided percutaneous localization and surgical biopsy of microcalcification in breast:Correlation between radiological and pathological findings

目的分析经数字化乳腺X线引导下导丝定位钙化切除活检证实的良恶性乳腺病变的X线征象,筛选有效客观影像学因子。方法收集接受数字化乳腺X线引导下导丝定位钙化切除活检的乳腺病变患者98例,分析并记录病变的X线征象[钙化类型、分布类型、分布范围、背景腺体密度、乳腺影像报告和数据系统(BI-RADS)分类],比较良恶性病变X线征象差异及BI-RADS 4类患者A、B、C亚类中良恶性病变构成比的差异。结果 98例中,良性病变72例(72/98,73.47%),恶性26例(26/98,26.53%)。良恶性病变的钙化类型、BI-RADS分类差异有统计学意义(P均<0.05);BIRADS类患者3三个亚类中,良恶性病变构成比差异有统计学意义(P=0.003),BI-RADS 4C中恶性病变比例最高(8/11,72.73%),BI-RADS 4A中良性病变比例最高(22/26,84.62%)。结论乳腺X线引导下导丝定位钙化切除活检术能够有效发现乳腺癌。钙化类型和BI-RADS分类是恶性乳腺钙化的有效影响因子。

Objective To analyze mammographic characteristics of benign and malignant lesions proved by surgical biopsy after digital mammography-guided percutaneous localization of microcalcification in breast, and to select effective objective factors. Methods Ninety-eight patients underwent preoperative digital mammography-guided percutaneous localization of microcalcification in breast and surgical biopsy. The image characteristics （type of calcification, type of calcification distribution, range of distribution, background density, breast imaging reporting and data system [BI-RADS]） were analyzed and recorded. Furthermore, image characteristics and components of benign and malignant lesions in BI-RADS 4A, 4B and 4C were compared. Results Benign and malignant lesions were detected in 72 （72/98, 73.47%） and 26 （26/98, 26.53%） patients, respectively. Type of calcification and BI-RADS grading were significantly different between benign and malignant lesions （all P〈0.05）. The components of benign and malignant lesions among 3 subgrades of BI-RADS 4 were significantly different （P=0. 003）, the most proportion of malignant lesions （8/11, 72.73%） was found in BI-RADS 4C, of benign ones （22/26, 84.62%） was found in BI-RADS 4A. Conclusion Digital mammography guided pereutaneous localization and surgical biopsy of microcalcification in breast could effectively detect breast cancer. The type of calcification and BIRADS grading are effective factors of differentiating malignant breast calcifications from benign ones.