自动乳腺全容积扫查系统对致密乳腺中乳腺癌的诊断价值

Automated breast volume scanner for the detection of breast cancer in dense breasts

目的评价自动乳腺全容积扫查（ABVs）系统、乳腺X线和手持式超声对致密乳腺中乳腺癌的诊断价值。方法回顾性分析162例乳腺癌合并致密乳腺（乳腺密度〉50％）的病例。所有病例术前经手持式超声、ABVS和乳腺X线检查，检查结果与活检结果相对照。结果162例患者中，171个病灶为乳腺癌，14个病灶为良性病变。ABVS的假阴性率为3．2％（6／185），而乳腺X线和手持式超声的假阴性率分别为37．8％（70／185）和10．8％（20／185）。ABVS的敏感性为96．5％（165／171），与手持式超声敏感性（88．3％，151／171）比较差异有统计学意义（P〈0．01）。手持式超声测量和病理学测量的151个病灶大小分别为（1．91±O．98）cm和（2．02±1．09）cm，两者比较差异有统计学意义（P〈0．01）。ABVS和病理学测量的165个病灶大小分别为（1．91±0．98）cm和（2．02±1．09）cm，两者比较差异无统计学意义（P=0．10）。结论ABVS诊断致密乳腺中乳腺癌的敏感性高，并且在测量病灶大小方面是有效的辅助影像措施。基于本研究结果，除微钙化灶之外的致密乳腺患者没有必要行乳腺X线检查，可直接行ABVS或乳腺MRI以减少放射线暴露。

Objective To evaluate the value of automated breast volume scanner （ABVS）, mammography （MMG） and handheld ultrasonography （HHUS） for the detection of breast cancer in dense breasts. Methods One hundred and sixty-two women with breast cancer and dense breasts （breast density 〉50 % ） were enrolled. All patients underwent preoperative ABVS, MMG,and HHUS, and the results were correlated with the biopsy results. Results In the 162 patients, 171 breast lesions were malignant tumors and 14 lesions were benign diseases. The false negative rate of ABVS was 3.2 % （6/185）, while the values of MMG and HHUS was 37.8% （70/185） and 10.8% （20/185）, respectively. The sensitivity of ABVS was 96.5%（165/171） ,which was significant difference from HHUS （88.3% ,151/171） （ P 〈0.01）.The size of 151 tumors on HHUS and pathology were （1.91 ±0.98）cm and （2.02 ±1.09）cm. There was significant difference in tumor sizes of HHUS and pathology （ P 〈0.01）.And the size of 165 tumors on ABVS and pathology were （2.04± 1.10）cm and （1.99 ±1.14）cm, there was no significant difference in tumor sizes of them （ P = 0.10）. Conclusions ABVS has high sensitivity for the detection of breast cancer in women with dense breasts and is an effective adjunct imaging modality in measuring tumor size. In order to minimize radiation exposure,women with dense breasts could be directly evaluated with ABVS or MRI, rather than MMG,except there were microcalcification in their breasts.