探讨数字乳腺断层摄影(digital breast tomosynthesis,DBT)对乳腺良恶性疾病的诊断价值,并与全数字化乳腺X线摄影(full-field digital mammography,FFDM)和乳腺超声结果进行比较。
方法:
回顾并分析2019年67月67例患者的临床资料,患者均接受FFDM、DBT及乳腺超声检查,并接受穿刺活检或手术后病理学检查。依照乳腺影像报告和数据系统(Breast Imaging Report and Data System,BI-RADS)评分分别计算DBT、FFDM和超声检查诊断乳腺良恶性病变的准确率、灵敏度、特异度。用Kappa分析分别评价DBT、FFDM、超声与病理学检查结果的一致性。用Fisher确切检验法,评价DBT、FFDM和超声检查对恶性病变的灵敏度、特异度差异。
To investigate the diagnostic value of digital breast tomosynthesis (DBT) in benign and malignant breast diseases
and compare with the results of conventional full-field digital mammography (FFDM) and br
east ultrasound (US).
Methods:
A retrospective analysis was made of 67 patients between Jun. and Jul. 2019
all of whom received FFDM
DBT and US
and were confirmed by biopsy or operation pathology. The accuracy
sensitivity
specificity of DBT
FFDM and US for benign and malignant breast lesions were evaluated according to Breast Imaging Report and Data System (BI-RADS) score.
Results:
The diagnostic accuracy of DBT
FFDM and US for benign and malignant breast lesions were 85.07%
64.18% and 76.12%. The sensitivity was 90.32%
67.74%
83.87% respectively
and the specificity was 80.56%
61.11%
69.44% respectively. DBT
FFDM and US were evaluated for consistency with pathological results
and Kappa values were 0.70
0.28 and 0.52
respectively. Comparison of the sensitivity of different examination methods in the detection of malignant lesions: the difference between DBT and FFDM was statistically significant (
P
0.05); the difference between DBT and ultrasound and the difference between FFDM and ultrasound was not statistically significant (
P
0.05). Different inspection methods for detection of malignant change sensitivity comparison: The highest specificity of DBT
but the specificity of the three methods had no significant difference in statistics (
P
>0.05).
Conclusion:
The sensitivity
specificity and accuracy of DBT in the diagnosis of benign and malignant breast lesions are higher than conventional FFDM and US
which are highly consistent with the pathological results. The sensitivity of malignant lesions evaluation is better than conventional FFDM
and DBT is a more sensitive examination method for breast cancer screening and diagnosis.