锥光束乳腺CT平扫对数字乳腺X线摄影漏诊病灶的检出效能探讨

Detection Efficiency of Cone-Beam Breast Computed Tomography Plain Scan on Missed Lesions by Digital Mammography

目的探讨锥光束乳腺CT(Cone-Beam Breast Computed Tomography,CBBCT)平扫对数字乳腺X线摄影(Digital Mammography,DM)漏诊病灶的检出效能。方法回顾性分析2020年10月至2021年2月同时接受CBBCT平扫和DM检查的患者,经纳入标准筛选后,入组20例患者,累计25个病灶。结果将25个病灶乳腺的CBBCT平扫诊断结果与其病理结果比较,Kappa=0.76,具有较高一致性;AUC值为0.92(95%CI:0.865~0.976),诊断效能较高。以乳腺影像报告和数据系统分类4a类为截断点,CBBCT诊断的灵敏度、特异度及约登指数分别为84.62%、91.67%、0.763。结论CBBCT平扫在c型及d型乳腺中评估DM不能检出的病灶方面具有优势,在临床发现乳腺病变而DM未见检出时,更宜选用CBBCT进行平扫检查。

Objective To investigate the efficacy of cone-beam breast computed tomography(CBBCT)plain scan in the detection of missed lesions by digital mammography(DM).Methods Patients who received CBBCT plain scan and DM examination from October 2020 to February 2021 were retrospectively analyzed.After inclusion criteria screening,20 patients were enrolled,with a total of 25 lesions.Results The CBBCT results of 25 breast lesions were compared with the pathological results,with Kappa=0.76,showing a high consistency.The AUC value was 0.92(95%CI:0.865-0.976),indicating high diagnostic efficiency.Using breast imaging reporting and data system classification 4a as the cut-off point,the sensitivity,specificity and Youden index of CBBCT were 84.62%,91.67%and 0.763,respectively.Conclusion CBBCT plain scan has advantages in the assessment of DM undetectable lesions in type c and d breast.It is recommend that CBBCT plain scan is more appropriate when breast lesions are clinically found but DM is not detected.