全数字化乳腺摄影、数字化乳腺断层摄影评估乳腺导管原位癌大小的准确性比较

Comparison of full field digital mammography and digital breast tomosynthesis in predicting size of ductal carcinoma in situ

目的比较全数字化乳腺摄影(FFDM)与数字化乳腺断层摄影(DBT)评估乳腺导管原位癌(DCIS)大小的准确率。方法分析30例病理确诊为乳腺DCIS的女性患者,由2名放射科医师在FFDM、DBT图像上测量病灶的大小,并与病理结果作对比。采用Pearson相关分析比较两种检查方法与病理结果的相关性。结果医师1和医师2的FFDM测量结果与病理结果呈正相关性(r=0.857、0.818,P均<0.01),医师1和医师2的DBT测量结果与病理结果呈正相关(r=0.924、0.885,P均<0.01);2名医师采用FFDM和DBT测量结果的组内相关系数(ICC)分别为0.947、0.908。结论FFDM、DBT均能较好评估乳腺DCIS大小,且与FFDM相比,DBT能更准确评估病灶的大小。2名医师对于病灶大小评估具有较高的一致性。对于存在钙化的DCIS,FFDM、DBT对于病灶的测量均小于病理测量结果,故临床手术可能需要切除更大的范围。

Objective To compare the accuracy of full field digital mammography（FFDM）and digital breast tomosynthesis（DBT）in predicting size of ductal carcinoma in situ（DCIS）.Methods Totally 30 women pateints with DCIS confirmed by histology were analyzed retrospectively.Two radiologists measured the size of the lesions on FFDM,DBT images respectively,and compared with pathological results.Two kinds of inspection methods correlation with pathology were compared with Pearsoncorrelation analysis.Results Size of DCIS measured by doctor 1and doctor 2between FFDM and histology had correlation（r=0.857,0.818,both P〈0.01）,and those between DBT and histology also had correlation（r=0.924,0.885,both P〈0.01）.Intraclass correlation coefficient（ICC）of two doctors was 0.947 on FFDM,and 0.908 on DBT.Conclusion DBT provides a better estimation of the size of DCIS.Two physicians had high consistency for lesion size evaluation.For DCIS with microcalcifications,both FFDM and DBT provide smaller estimations compared with pathology,thus a bigger surgical resection of lesion is needed.