对比增强能谱乳腺X线摄影联合超声在乳腺癌中的应用研究

The application of contrast-enhanced energy spectrum mammography combined with ultrasound in breast cancer

目的:研究对比增强能谱乳腺X线摄影(CESM)联合超声在乳腺癌中的临床价值,分析乳腺病灶良恶性评估的诊断效能,提高乳腺癌疾病诊断准确性。方法:回顾性分析本院2019年6月-2020年4月临床诊断的126例乳腺疾病患者的病例资料,所有患者均行CESM检查、超声检查及病理诊断,分析单项检查及联合检查诊断乳腺疾病的符合率,对单项检查乳腺癌病灶测量与病理测量值进行一致性分析,比较CESM、超声与联合检查对乳腺癌疾病诊断效能。结果:以病理诊断为金标准,确诊38例乳腺癌患者,CESM乳腺癌检出率84.21%(32/38)高于超声恶性检出率78.94%(30/38),差异无统计学意义(χ^(2)=0.350,P>0.05)。CESM和超声测量值与病理测量值呈正相关(r=0.943、0.766,P均<0.001)。诊断乳腺癌效能分析显示,联合检查敏感度、特异度、符合率、阴性预测值及阳性预测值均高于单项CESM、超声检查。结论:CESM与超声联合检查在诊断乳腺癌疾病中能提高疾病灵敏度、特异度及准确率,具有很好的临床应用价值。

Objective:To study the clinical value of contrast-enhanced spectral mammography(CESM)combined with ultrasound in breast cancer,and analyze the diagnostic efficiency in differentiating benign and malignant breast lesions,and then to improve the diagnostic accuracy of breast cancer.Methods:A retrospective analysis of 126 cases with clinically diagnosed breast disease was performed in our hospital from June 2019 to April 2020.All patients underwent CESM examination,ultrasound examination and pathological diagnosis.We analyzed the accuracy of single and combined examinations in the diagnosis of breast disease,and performed a consistency analysis between single examination and pathological measurement in lesion measurement,and compared the diagnostic efficacy of CESM,ultrasound and combined examinations for breast cancer.Results:Regarding the pathological diagnosis as the gold standard,38 cases of breast cancer were diagnosed.The detection rate of CESM for breast cancer was 84.21%(32/38)higher than the ultrasound detection rate of 78.94%(30/38),but without statistically significant(χ^(2)=0.350,P>0.05).CESM and ultrasound measurements were positively correlated with pathological measurements(r=0.943,0.766,both P<0.001).The efficiency analysis of the diagnosis of breast cancer showed that the sensitivity,specificity,accuracy,negative predictive value,and positive predictive value of the combined examination are higher than those of single examination,i.e.,CESM and ultrasound.Conclusion:The combination of CESM and ultrasound can improve the sensitivity,specificity and accuracy in diagnosing breast cancer,and has good clinical application value.