电阻抗断层成像与乳房超声及钼靶在诊断乳腺良恶性病变中的对照观察

Utflisation of electrical impedance tomography and/or ultrasound and mammography in breast disease diagnosis： a controlled study

目的探讨一种新的电阻抗断层成像技术（EIT）对乳腺良恶性疾病的诊断价值，并与传统的影像学检查乳房超声和钼靶的结果进行比较。方法2016年5至8月来北京朝阳医院乳腺外科就诊的121例患者，共126个乳腺结节接受钼靶、超声及EIT检查，均经穿刺活检或手术病理证实，计算EIT、超声和钼靶检查对乳腺病变的准确率、敏感度、特异度、阳性预测值、阴性预测值。结果EIT、超声及钼靶检查对乳腺良恶性病变诊断的准确率分别为75．4％、81．7％、76．1％，敏感度分别为76．8％、94．6％、74．4％，特异度分别为74．3％、71．4％、77．6％，EIT结合超声诊断乳腺病变的准确度、敏感度和特异度分别为91．3％、98．2％、85．7％，在准确度和特异度方面显著高于超声检查（χ^2=4．896，P=0．027；χ^2=4．242，P=0．039），EIT联合钼靶对乳腺病变的诊断准确率、敏感度及特异度分别为95．5％，97．4％，93．9％，均显著高于钼靶检查（χ^2=13．474，P〈0．001；χ^2=8．573，P=0．003；χ^2=5．333，P=0．021）。结论电阻抗断层成像对超声和钼靶在诊断乳腺疾病时有良好的互补性，且能够对乳腺进行代谢评估，有望用于早期筛查。

Objective To investigate the diagnostic accuracy of electrical impedance tomography （EIT） for benign and malignant breast diseases incomparison to conventional ultrasonography and mammography. Methods A total of 121 patients with 126 breast lesions who underwent mammography ultrasonography and EIT were enrolled in the study. All of these lessions were were confirmed by pathological biopsy. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EIT, ultrasonography and mammography were calculated with histology as the gold standard. Results The accuracy of EIT, ultrasonography and mammography were 75.4%, 81.7% and 76. 1% respectively. The sensitivity was 76. 8%, 94. 6% and 74. 4% respectively. The specificity was 74. 3%, 71.4% and 77.6% respectively. The accuracy, sensitivity and specificity of EIT combined with ultrasound in diagnosis of breast lesions were 91.3% , 98.2% and 85. 7% , respectively. The accuracy （χ^2 = 4. 896, P = 0. 027） and specificity（ χ^2 =4. 242 ,P = 0. 039 ） ere significantly higher on EIT compared to ultrasound. The accuracy, sensitivity and specificity of EIT combined with mammography were 95.5%, 97.4% and 93.9%, respectively, which were significantly higher than those of mammography （ χ^2 = 13. 474, P 〈 0. 001 ; χ^2 = 8. 573 ,P =0. 003 ; χ^2 =5. 333 ,P =0. 021 ）. Conclusion When together with ultrasound or mammography, electrical impedance tomography （EIT） could be a valuable complementary examination in the diagnosis of breast diseases. Furthermore, EIT could provide very useful additional information for metabolic assessment of mammary glands.which mav be used for earlv sereening of breast diseases.