对比增强乳腺摄影与全数字化乳腺摄影对乳腺癌诊断效能的比较

Contrast-enhanced mammography vs full-field digital mammography in diagnosing breast cancer

目的:前瞻性地比较对比增强乳腺摄影(CESM)与常规全数字化乳腺X线摄影(FFDM)的诊断效能。方法:将2018年5月至2021年2月本院临床怀疑乳腺异常病变的69例患者纳入研究。所有患者完成FFDM及CESM检查。由3位有经验的乳腺影像诊断医师对所有图像进行分析,每种成像技术的诊断结果均与病理结果进行对照,并进行统计分析。结果:69例患者中,共检出75个病变,其中恶性病变34个,良性病变41个。CESM诊断乳腺癌的敏感性为97.1%(FFDM为70.6%),特异性为90.2%(FFDM为85.4%),阳性预测值为89.2%(FFDM为80.0%),阴性预测值为97.4%(FFDM为77.8%),准确率为93.3%(FFDM为80.0%),受试者ROC特征曲线下面积为0.937(FFDM为0.780)。结论:CESM对乳腺癌的诊断具有较高的敏感性、阴性预测值和诊断准确率。与FFDM相比,CESM具有更好的诊断效能及临床应用价值。

Objective:To compare the diagnostic performance of contrast-enhanced mammography(CESM)and full-filed digital mammography(FFDM)in a prospective study.Methods:Between May 2018 and February 2021,69 patients with clinically suspected breast disorders in our hospital were enrolled in the study.All patients completed FFDM and CESM.All images were analyzed by three experienced specialists of breast imaging diagnostics.The diagnoses by each of the two imaging modalitieswere compared with pathological findings,and subjected to statistical analysis.Results:A total of 75 lesions were detected in 69 patients,34 malignant and 41 benign.Compared with FFDM,the sensitivity of CESM in diagnosing breast cancer was 97.1%vs 70.6%,the specificity was 90.2%vs 85.4%,the positive predictive value was 89.2%vs 80.0%,the negative predictive value was 97.4%vs 77.8%,the accuracy was 93.3%vs 80.0%,and the area under the ROC characteristic curve was 0.937 vs 0.780.Conclusion:CESM offers high sensitivity,negative predictive value and diagnostic accuracy for diagnosing breast cancer.Compared with FFDM,CESM shows better diagnostic efficiency and clinical value.