数字乳腺X线摄影与数字乳腺断层摄影对乳腺病变的诊断价值比较

Comparison of Diagnostic Value of Digital Mammography and Digital Breast Tomosynthesis in Breast Lesions

目的比较数字乳腺X线摄影(DM)与数字乳腺断层摄影(DBT)对乳腺病变的诊断价值。方法回顾性收集2020年1月1日至2021年1月1日郑州大学第一附属医院收治的乳腺疾病患者的临床资料。患者于入院1周内行DM和DBT检查。全部病例均经活检或手术证实,具有完整的临床病理资料。由2名高年资医生分别观察DM图像和DBT图像,记录病灶检出情况、病灶影像学特征及乳腺影像报告和数据系统(BI-RADS)分类结果。结果共纳入165例患者,包括196个病灶,其中良性病灶106个,恶性病灶90个。DM与DBT对非致密型乳腺内病灶的诊断准确率、敏感性、特异性、阳性预测值及阴性预测值比较,差异无统计学意义(P>0.05);两者曲线下面积(AUC)比较,差异无统计学意义(P>0.05)。DBT对致密型乳腺内病灶的准确率及特异性高于DM(P<0.05);DBT的AUC值高于DM(P<0.05)。DBT对单纯肿块型病变、结构扭曲型病变的检出率高于DM(P<0.05)。结论DBT对致密型乳腺内病灶的诊断准确性、特异性优于DM。DBT对肿块型病变及结构扭曲的检出效能优于DM。

Objective To compare the diagnostic value of digital mammography(DM)and digital breast tomosynthesis(DBT)in breast lesions.Methods The clinical data of patients with breast diseases admitted to the First Affiliated Hospital of Zhengzhou University from January 1,2020 to January 1,2021 were collected retrospectively.The patients were examined by DM and DBT within one week after admission.All cases were confirmed by biopsy or surgery,with complete clinicopathological data.Two senior doctors observed DM images and DBT images respectively,and recorded the detection of lesions,the imaging features of lesions and the classification results of breast imaging report and data system(BI-RADS).Results A total of 165 patients were included,including 196 lesions,of which there were 106 benign lesions and 90 malignant lesions.Compared with the diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of DM and DBT for non-dense breast lesions,there was no statistical difference(P>0.05).There was no statistical difference in area under the curve(AUC)between them(P>0.05).The accuracy and specificity of DBT for dense breast lesions were higher than those of DM(P<0.05),and the AUC value of DBT was higher than that of DM(P<0.05).The detection rates of simple lump lesions and distorted lesions of DBT were higher than those of DM(P<0.05).Conclusion The diagnostic accuracy and specificity of DBT for dense breast lesions are better than those of DM.The detection efficiency of DBT for mass lesions and structural distortion is better than that of DM.