数字乳腺断层摄影在乳腺疾病中的诊断价值研究

Study on the value of digital breast tomography in diagnosis of breast diseases

目的探讨数字乳腺断层摄影(breast tomosynthesis,DBT)在乳腺良恶性病变中的诊断价值。方法选择2017年1月—2018年10月在本院放射科就诊的111例患者作为研究对象。所有患者均行数字乳腺断层摄影(DBT)检查及全数字化乳腺摄影(full-field digital mammography,FFDM),且全部经病理证实。依据第四版美国放射学会乳腺影像报告和数据系统,以病理结果为金标准,统计分析两种影像检查方法的敏感度、特异度、符合率、阳性预测值和阴性预测值并采用卡方检验进行比较。采用受试者工作特征性曲线(receiver operating characteristic curve,ROC)下面积(area under curve,AUC)评估两种影像检查方法对乳腺病变的综合诊断效能。结果 111例患者中共122个乳腺病变,其中恶性肿瘤43个,良性病变79个。DBT与FFDM的敏感度及特异度之间差异均有统计学意义(P<0.05),阳性预测值及阴性预测值无统计学意义(P>0.05)。DBT的AUC高于FFDM,且差异有统计学意义(Z=3.789,P=0.0002)。结论DBT与FFDM相比能提高乳腺疾病的综合诊断效能,具有一定的临床意义和价值。

Objective To investigate the diagnostic value of digital breast tomosynthesis(DBT) in diagnosing benign and malignant breast lesions.Methods A total of 111 patients visit the department of radiology of the first affiliated hospital of Bengbu Medical College from January 2017 to October 2018 were collected.All patients underwent digital mammography(DBT) and full-field digital mammography(FFDM),and all confirmed by pathology.According to the fourth edition of the American Radiological Society’s breast imaging report and data system,the pathological results were used as the gold standard.Statistical methods were used to calculate the sensitivity,specificity,coincidence rate,positive predictive value and negative predictive value of the two imaging methods and compared by chi-square test.Comprehensive diagnostic efficacy of the two imaging methods for breast lesions was compared by using the area under the receiver’s characteristic curve.Results Among the 111 cases of patients,122 breast lesions were found,including 43 malignant tumors and 79 benign lesions.There was a statistically significant difference in sensitivity and specificity between the DBT and FFDM.There was no statistically significant difference in predictive value and negative predictive value between.The AUC of DBT was higher than FFDM,and the difference was statistically significant(Z = 3.789,P = 0.0002).Conclusions Compared with FFDM,DBT could improve the comprehensive diagnostic efficacy for breast diseases,and has certain clinical significance and value.