摘要
目的探讨数字乳腺断层摄影(DBT)与全视野数字化乳腺摄影(FFDM)、超声及MRI对致密型乳腺肿块型病变的诊断效能。方法由高、低年资医师各1位回顾性分析2022年1~12月本院在同时行FFDM及DBT检查的223个致密型乳腺的肿块型病灶以及同时行FFDM、DBT、超声及MRI检查的97个致密型乳腺的肿块型病变,分别进行BI-RADS分级,定义4a级及以下为良性,4b级及以上为恶性;所有患者均行手术获取病理诊断作为金标准;采用Kappa一致性检验与ROC曲线对比高低年资使用FFDM及DBT的诊断效能,以及FFDM、DBT、FFDM联合DBT、超声与MRI在乳腺肿块型病变中的诊断效能。结果高年资医师DBT诊断与病理结果有较高程度一致性(Kappa=0.712),低年资医师FFDM诊断效能低于低年资医师DBT及高年资医师FFDM及DBT(AUC=0.610、0.808、0.652、0.855);DBT、FFDM+DBT及MR检查的诊断结果与病理金标准均有较高一致性,且一致性递增(Kappa=0.688、0.707、0.792),在全部肿块型病变中,FFDM、FFDM+DBT与MRI对乳腺肿物的诊断效能逐渐升高(AUC=0.690、0.815、0.888)。结论DBT技术能显著提升医师对肿块型病变的诊断能力,对于低年资医师提升效果更为显著,诊断效能接近MRI水平;DBT与FFDM+DBT相比较,其病理一致性稍弱,但诊断效能相当。
Objective To investigate the diagnostic effectiveness of digital breast tomosynthesis(DBT),full-field digital mammography(FFDM),ultrasound and MRI in the diagnosis of dense breast lesions.Methods A retrospective analysis was conducted by two experienced and inexperienced radiologists on 223 dense breast lesions that underwent both FFDM and DBT examinations,as well as a retrospective analysis on 97 dense breast lesions that underwent both FFDM,DBT,ultrasound,and MRI examinations.The dense breast lesions were diagnosed as benign(BI-RADS grade 4a and below)or malignant(BIRADS grade 4b and above),based on the images of FFDM,DBT,ultrasound and MRI,respectively.All patients underwent surgery to get a pathological diagnosis.Kappa consistency tests and ROC curve were used to compare the efficacy of high-and low-experience radiologists,as well as FFDM,DBT,FFDM+DBT,ultrasound,and MRI in the diagnosis of dense breast lesions.Results In the comparison between senior and junior radiologists using FFDM and DBT,the senior radiologist use DBT to diagnose dense breast lesions had a high degree of consistency with the pathological results(Kappa=0.712),while the junior radiologist use FFDM diagnosis efficiency was lower than that of the junior radiologist use DBT and the senior radiologist use FFDM and DBT(AUC=0.610,0.808,0.652,0.855).In the comparisons between FFDM,DBT,FFDM+DBT,ultrasound and MRI,the diagnostic results of DBT,FFDM+DBT and MR examinations had high consistency with the pathological gold standard,and the consistency increased(Kappa=0.688,0.707,0.792).In all dense breast lesions,the diagnostic efficacy of FFDM,FFDM+DBT and MRI increased gradually(AUC=0.690,0.815,0.888).Conclusion Both junior and senior radiologists can improve their diagnostic efficiency by using the DBT examination method,and the improvement in diagnostic efficiency for junior radiologists is more significant.Radiologists can significantly improve the diagnostic efficiency of mammography by using the DBT technology,and the diagnostic efficiency is equivalent to that of MR.The pathological consistency of DBT is slightly lower than that of FFDM+DBT,but the diagnostic efficiency is equivalent.
作者
胡碧莹
黎家强
罗纯
周涛
罗嘉欣
莫淑琼
于凡
HU Biying;LI Jiaqiang;LUO Chun;ZHOU Tao;LUO Jiaxin;MO Shuqiong;YU Fan(Department of Radiology,The First People's Hospital of Foshan,Foshan 528000,China)
出处
《分子影像学杂志》
2024年第11期1200-1206,共7页
Journal of Molecular Imaging
基金
佛山市卫生健康局医学科研课题(20220065)
佛山市“十四五”医学重点专科和培育专科(FSGSP145036)。
关键词
乳腺断层融合摄影
致密型乳腺
诊断效能
digital breast tomosynthesis
dense breast
diagnostic efficiency