对比增强乳腺X线摄影联合常规超声可提高BI-RADS 3～5类乳腺乳头状病变的诊断效能
Contrast-enhanced mammography combined with ultrasound can improve the diagnostic efficiency of BI-RADS 3-5 papillary breast lesions
盛洁 1曾辉 2陈卫国 2曾凤霞 2秦耿耿 2徐维敏3
作者信息
- 1. 惠州市第三人民医院放射科,广东 惠州 516002;南方医科大学南方医院 影像诊断科,广东 广州 510515
- 2. 南方医科大学南方医院 影像诊断科,广东 广州 510515
- 3. 南方医科大学南方医院 影像诊断科,广东 广州 510515;南方医科大学南方医院 超声医学科,广东 广州 510515
- 折叠
摘要
目的 探讨对比增强乳腺X线摄影(CEM)联合常规超声对乳腺乳头状病变的良恶性鉴别诊断价值.方法 回顾性分析2020年1月～2024年7月术前同时行CEM和超声检查并经病理学检查证实乳腺乳头状病变70例女性患者的临床资料,同时分析病灶CEM及超声特征.以病理结果为金标准,评价单独CEM、单独超声、CEM+超声对乳腺乳头状病变的诊断效能.结果 70例患者良性病变48例(包括导管内乳头状瘤),高危+恶性病变22例(包括导管内乳头状瘤伴不典型增生4例及乳头状癌18例),共检出90个病灶.其中CEM+超声的AUC最高,约为0.863.CEM+超声的特异度及准确率最高,分别约为79.1%和84.2%;而CEM+超声与单独CEM的敏感度及阴性预测值相近,分别为95.5%vs 95.5%、97.4%vs 97.1%.结论 CEM形态学联合超声特征综合判断提高了BI-RADS 3～5类乳腺乳头状病变的诊断效能,一定程度降低了良性病变的活检率,且提高了恶性病变的检出率.
Abstract
Objective To investigate the advantages of incorporating morphological analyses of contrast-enhanced mammography(CEM)and ultrasound for various subtypes of papillary breast lesions,and to compare the diagnostic characteristics and performance of this imaging method in distinguishing between these subtypes.Methods This study involved 70 female patients diagnosed with papillary breast lesions from January 2020 to July 2024.For each patient,BI-RADS lesion features of the CEM and ultrasound were recorded.And the different measurements of diagnostic performance were recorded.Results Among the 70 female patients,90 lesions were identified,including 18 malignant ones,4 intraductal papillomas without atypical proliferation,and 48 benign papillary lesions.The areas under ROC curves for CEM combined with ultrasound was 0.863.Specificity and accuracy of CEM combined with ultrasound showed highest values was 79.1%and 84.2%,respectively.However,the sensitivity and negative predictive value of the CEM with ultrasound were similar to those of CEM alone.Conclusion For BI-RADS 3-5 papillary breast lesions,incorporating CEM combined with ultrasound can improved the confidence level in diagnosis.
关键词
对比增强乳腺X线摄影/超声/乳腺/乳头状病变Key words
contrast-enhanced spectral mammography/ultrasound/breast/papillary引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据