SPECT/CT显像、常规超声及钼靶成像对乳腺癌腋窝淋巴结转移的诊断效能分析

Diagnostic efficacy of SPECT/CT,conventional ultrasound and mammography for axillary lymph node metastasis in breast cancer

目的:评价SPECT/CT显像、常规超声及钼靶成像对乳腺癌腋窝淋巴结转移的诊断效能。方法:回顾性分析我院2013年03月至2016年11月期间收治的42例乳腺癌患者的99 Tc m-SPECT/CT显像、常规超声及钼靶成像结果,以术后病理结果为标准,评价各种显像诊断方法的灵敏度、特异度、准确度及一致性。结果:SPECT/CT显像诊断乳腺癌腋窝淋巴结灵敏度、准确度(88.5%、81.0%)明显优于常规超声(50.0%、59.5%)及钼靶成像(26.9%、45.2%)。特异度三种方法无显著性差异;SPECT/CT显像结果与病理检验结果一致性分析(Kappa=0.59)优于常规超声(Kappa=0.25)及钼靶成像(Kappa=0.13)。SPECT/CT显像发现腋窝淋巴结转移阳性率(66.7%),显著高于钼靶成像(26.2%)及常规超声成像(40.5%),二者均有统计学意义(P<0.05)。ROC曲线分析SPECT/CT显像靶病灶与本底放射性计数比值截断值为3.55,对应的灵敏度、特异度、准确度为81%、94%、86%。结论:SPECT/CT显像在术前诊断乳腺癌腋窝淋巴结转移方面具有较好的诊断价值,与病理诊断有较好的一致性。

Objective:To evaluate the diagnostic efficacy of SPECT/CT imaging,conventional ultrasound and mammography in the diagnosis of axillary lymph node metastasis in breast cancer.Methods:The sensitivity,specificity,accuracy and consistency of various diagnostic methods were evaluated by retrospective analysis of 99 Tc m-SPECT/CT imaging,conventional ultrasound and Molybdenum target imaging in 42 breast cancer patients admitted from March 2013 to November 2016.Results:The sensitivity and accuracy(88.5%,81.0%)of axillary lymph nodes in diagnosis of breast cancer were significantly better than those of conventional ultrasound(50.0%,59.5%)and Molybdenum target(26.9%,45.2%).There was no significant difference in the specificity of the three methods.The consistent analysis of SPECT/CT results and pathological results(Kappa=0.59)was superior to conventional ultrasound(Kappa=0.25)and Molybdenum target imaging(Kappa=0.13).SPECT/CT imaging found that the positive rate of axillary lymph node metastasis was 66.7%,which was significantly higher than that of Molybdenum target imaging(26.2%)and conventional ultrasound imaging(40.5%),both of which were statistically significant(P<0.05).The ROC curve analysis of SPECT/CT target and background radiation count ratio was 3.55,and the corresponding sensitivity,specificity,and accuracy were 81%,94%and 86%.Conclusion:SPECT/CT imaging has good diagnostic value in preoperative diagnosis of axillary lymph node metastasis of breast cancer and is consistent with pathological diagnosis.