2018 年第 11 期 第 13 卷

全屏数字化乳腺X线成像和乳腺断层融合X线成像与磁共振成像在乳腺癌诊断中的应用

Full-field digital mammography, digital breast tomosynthesis and magnetic resonance imaging in diagnosis of breast cancer

作者：张进荣吴小燕

英文作者：

单位：032200山西省汾阳医院放射科

英文单位：

关键词：乳腺癌；全屏数字化乳腺X线成像；磁共振成像；乳腺断层融合X线成像

英文关键词：

• 摘要：

• 【摘要】目的    探讨全屏数字化乳腺X线成像（FFDM）和乳腺断层融合X线成像（DBT）及磁共振成像（MRI）在乳腺癌诊断中的应用价值。方法    选取2017年1月至2018年4月于山西省汾阳医院经手术病理证实的女性乳腺癌患者31例，均行FFDM、DBT及MRI检查。以手术病理结果作为金标准，评价单纯FFDM、FFDM联合DBT、单纯MRI诊断乳腺癌的准确性，应用受试者工作特征曲线分析3种方法诊断乳腺癌的效果。结果    31例患者中，FFDM检查6例未能显示病灶，5例隐约显示病灶，20例明确显示病灶；FFDM联合DBT检查4例未能显示病灶，5例隐约显示病灶，22例明确显示病灶；MRI检查3例未能显示病灶，5例隐约显示病灶，23例明确显示病灶。单纯FFDM、FFDM联合DBT及单纯MRI诊断乳腺癌的受试者工作特征曲线下面积分别为0.825、0.892、0.905。FFDM联合DBT及单纯MRI诊断乳腺癌的曲线下面积大于单纯FFDM，差异均有统计学意义(均P＜0.05）,FFDM联合DBT与单纯MRI诊断乳腺癌的曲线下面积比较，差异无统计学意义（P＞0.05）。结论    FFDM联合DBT和单纯MRI检查诊断乳腺癌的效果优于单纯FFDM，而FFDM联合DBT和单纯MRI对乳腺癌的诊断效果相当。

• 【Abstract】Objective    To investigate the diagnostic values of full-field digital mammography(FFDM), digital breast tomosynthesis(DBT) and magnetic resonance imaging(MRI) in breast cancer. Methods    Between January 2017 and April 2018, 31 cases of breast cancer confirmed by surgical pathology in Fenyang Hospital of Shanxi Province were included. All patients had FFDM, DBT and MRI examination. Diagnostic efficiency of the three methods was analyzed by receiver operating characteristic（ROC） curve. Results    FFDM showed the clear diagnosis of breast cancer in 20 cases; it failed to identify the tumor in 6 cases; it showed a suspicious diagnosis of cancer in 5 cases. In the diagnostic results of FFDM combined with DBT, 22 cases showed clear foci of breast cancer; 5 cases showed suspicious lesion; 3 cases were failed to be identified. Area under ROC curve（AUC） of FFDM alone, FFDM combined with DBT and MRI alone in diagnosing breast cancer was 0.825, 0.892 and 0.905, respectively. AUCs of FFDM combined with DBT and MRI alone in diagnosis of breast cancer were larger than that of FFDM alone(P＜0.05). There was no significant difference of the AUC between FFDM combined with DBT and MRI alone(P＞0.05). Conclusion    FFDM combined with DBT has better diagnostic efficacy than FFDM alone in breast cancer; it has equal diagnostic value to MRI.