数字乳腺断层摄影(DBT)与全数字化乳腺摄影(FFDM)对乳腺病变诊断效能的对比

Comparions of the Diagnostic Value between Digital Breast Tomosynthesis and Full-field Digital Mammography

目的研究数字乳腺断层摄影(digital breast tomosynthesis,DBT)对于乳腺病变诊断的效能。方法选取2017年9月至2019年9月在昆明市延安医院就诊的乳腺疾病患者151例,患者全部进行CC位及MLO位DBT和全数字化乳腺摄影(Full-field Digital Mammography,FFDM)拍摄。结果DBT诊断乳腺良、恶性病变的特异性、敏感性、阳性预测值、阴性预测值和准确性均明显高于FFDM,而敏感性、阳性预测值、阴性预测值和准确性稍低于FFDM+DBT,差异有统计学意义(P﹤0.05);对于肿块病灶,DBT诊断乳腺病变的特异性、敏感性、阳性预测值、阴性预测值和准确性均高于单独FFDM,差异有统计学意义(P﹤0.05),DBT与DBT+FFDM诊断效能相当;对于致密型腺体内病灶,DBT诊断乳腺病变的特异性、敏感性、阳性预测值、阴性预测值和准确性均明显高于单独FFDM,差异有统计学意义(P﹤0.05),DBT诊断乳腺病变的敏感性、阳性预测值、阴性预测值和准确性低于DBT+FFDM,差异有统计学意义(P﹤0.05)。结论对比单独FFDM,DBT+FFDM及单独DBT均明显提高了乳腺疾病诊断的准确性,尤其对于致密型乳腺;FFDM+DBT较DBT略有优势。

Objective To investigate the diagnosistic efficiency of digital breast tomosynthesis(DBT)in breast diseases.Methods 151 women with a clinically suspicious breast disease during Sept.2017 to Sept.2019were enrolled into the study and all of them received full-field digital mammography(FFDM)and DBT examinations in Yan’an Hospital of Kunming.Results The specificity,sensitivity,positive predictive value,negative predictive value and accuracy of DBT in diagnosing benign and malignant breast lesions were significantly higher than those of FFDM,while the sensitivity,positive predictive value,negative predictive value and accuracy were slightly lower than those of FFDM+DBT(P<0.05);The specificity,sensitivity,positive predictive value,negative predictive value and accuracy of DBT in diagnosing breast lesions were higher than those of FFDM alone(P<0.05).The diagnostic efficacy of DBT and DBT+FFDM was comparable;For dense intraglandular lesions,the specificity,sensitivity,positive predictive value,negative predictive value and accuracy of DBT in diagnosing breast lesions were significantly higher than those of FFDM alone(P<0.05).The sensitivity,positive predictive value,negative predictive value and accuracy of DBT in diagnosing breast lesions were lower than those of DBT+FFDM(P<0.05)Conclusion As compared with FFDM,DBT+FFDM and DBT significantly can improve the accuracy of breast disease diagnosis,especially for dense breast;FFDM+DBT has some advantages over DBT.