对比传统影像学检查方法与对比增强乳腺X线摄影(contrast-enhanced digital mammography,CEDM)术前测量乳腺癌肿块大小的能力。
方法:
回顾并研究经病理学检查证实为乳腺癌的105例患者的临床资料,所有患者均行全数字化乳腺X线摄影(full-field digital mammography,FFDM)、超声、磁共振成像(magnetic resonance imaging,MRI)及CEDM检查。由3名经验丰富的放射科医师和1名超声科医师分别测量目标肿块最大径,利用方差分析比较上述检查方法与术后大体标本测量值之间的差异;利用Pearson相关系数分析上述方法所获结果与病理学测量值之间的一致性,同时采用配对t检验评价CEDM术前评估肿块大小的效能。
To compare the efficacy of contrast-enhanced digital mammography (CEDM) with conventional imaging methods in assessing the size of breast cancer mass before surgery.
Methods:
A total of
105 breast cancer patients confirmed by pathology were collected in this study. All patients underwent full-field digital mammography (FFDM)
ultrasound
magnetic resonance imaging (MRI) and CEDM. Three experienced radiologists and one sonographer respectively measured the longest diameter of the target mass
and compared the difference between the above inspection methods and the postoperative gross specimen measurement value by analysis of variance; Pearson correlation coefficient was used to analyze the agreement between the resultsobtained by the above ethods and the pathological measurement values
and the paired t test was used to evaluate the efficacy of CEDM in evaluating the size of the tumor before surgery.
Results:
A total of 118 masses were found in 105 patients
while 15 masses were excluded for the patients received operation after adjuvant chemotherapy. Finally
103 masses with measurable tumor size were included for further research. There was no significantly difference between the maximum tumor size measured by CEDM
MRI and gross specimen group (both
P
>0.05)
while there was remarkable difference between the gross specimen group and FFDM (
t
=2.76
P
=0.010 5)
or the ultrasound (
t
=3.68
P
=0.000 9) group. The coefficient of correlation with pathological data of CEDM (
r
=0.89) and MRI (
r
=0.86) were significantly higher than those of ultrasound (
r
=0.71) and FFDM (
r
=0.68).
Conclusion:
CEDM and MRI are superior to FFDM and ultrasound in the preoperative assessment of breast tumor size. As a new mammography technology
CEDM has good clinical application prospect in preoperative staging of breast cancer.