Diagnostic value of contrast-enhanced spectral mammography

ZHANG Zhengwei; JIN Biao; GU Yajia

doi:10.19732/j.cnki.2096-6210.2020.02.012

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Diagnostic value of contrast-enhanced spectral mammography

更新时间：2025-12-15

- Diagnostic value of contrast-enhanced spectral mammography
- Vol. 29, Issue 2, Pages: 141-147(2020)
- 作者机构：
  
  上海交通大学医学院附属新华医院放射诊断科，上海 200092 2. 复旦大学附属肿瘤医院放射诊断科，复旦大学上海医学院肿瘤学系,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2020.02.012
  CLC：
- Published Online：28 April 2020，
  
  Published：28 April 2020
- 稿件说明：
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张征委,金彪,顾雅佳. 对比增强能谱乳腺X线摄影的诊断价值分析[J]. 肿瘤影像学, 2020, 29(2): 141-147 https://doi.

org/10.19732/j.cnki.2096-6210.2020.02.012
张征委,金彪,顾雅佳. 对比增强能谱乳腺X线摄影的诊断价值分析[J]. 肿瘤影像学, 2020, 29(2): 141-147 https://doi. DOI： 10.19732/j.cnki.2096-6210.2020.02.012.

org/10.19732/j.cnki.2096-6210.2020.02.012 DOI：

摘要

目的：

探讨分析对比增强能谱乳腺X线摄影（contrast-enhanced spectral mammography，CESM）在乳腺病灶的检出及鉴别良恶性方面的应用。

方法：

前瞻性纳入临床怀疑或超声发现乳腺病变后进一步行CESM检查的患者，最终151例患者（157个病灶）纳入本次研究。阅读并评价低能图、CESM及磁共振成像（magnetic resonance imaging，MRI）表现，采用受试者工作特征（receiver operating characteristic，ROC）曲线分析低能图、CESM及MRI的诊断效能，用Z检验比较曲线下面积（area under curve，AUC），计算灵敏度、特异度及准确率。根据患侧乳腺密度分为致密型乳腺、非致密型乳腺，作亚分组分析。

结果：

低能图在128例患者中检出134个病灶，其中浸润性癌39个，非浸润性癌3个，和92个良性病变。CESM在148例患者中检出154个病灶，其中44个恶性病灶，110个良性病变。CESM与低能图的AUC分别为0.97、0.89（

＜0.05）。致密型乳腺组CESM与低能图AUC分别为0.97、0.87（

＜0.05）。53例完成MRI检查的患者中，低能图、CESM及MRI三者的AUC分别为0.90、0.97、0.98（

＞0.05）。

结论：

CESM在病灶检出及诊断准确率上优于低能图，与MRI之间差异不显著，CESM在致密型乳腺中有更好的表现。

Abstract

Objective:

To explore diagnostic value of contrast-enhanced spectral mammography (CESM) in the detection and differentiation of breast lesions.

Methods:

The study included 151 patients with 157 breast lesions. After the lesions were observed on low energy (LE)

CESM and magnetic resonance imaging (MRI) images

Receiver operating characteristic (ROC) curves were compared

and calcul

ate the sensitivity

specificity and accuracy. According to the density of the affected breast

it can be divided into dense breast and non-dense breast.

Results:

The LE detected 134 lesions in 128 patients

including 39 invasive

3 non-invasive

and 92 benign. With CESM

154 lesions in 148 patients were detected

including 44 malignant lesions and 110 benign lesions. The area under curve (AUC) of CESM and LE was 0.97 and 0.89 (

＜0.05). In dense breast group

the AUC of CESM and LE were 0.97 and 0.87 (

＜0.05). The AUC of LE

CESM and MRI were 0.90

0.97 and 0.98

respectively

(

＞0.05).

Conclusion:

CESM is superior to LE in detection and diagnosis of lesions

and there is no significant difference between CESM and MRI. CESM has a better perfor-mance in dense breast.

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