Comparison of mammography and ultrasonography in benign and malignant structural distortion
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摘要:
目的研究乳腺X线摄影（全数字化乳腺摄影与数字乳腺断层摄影）及彩超对于结构扭曲良恶性病变诊断效能对比研究及结构扭曲在X线征象的分析方法。 方法收集本院2013年6月~2018年12月就诊的51例乳腺疾病患者，年龄20~70岁（44.84±8.738岁），均接受全数字化乳腺摄影、数字乳腺断层摄影及彩超检查且发现单纯结构扭曲征象，同时具有病理结果，根据乳腺影像报告和数据系统进行阅片诊断，比较3种影像学方法的诊断效能及结构扭曲的征象分析。 结果Fisher精确算法分析显示，结构扭曲X线征象（中心密度、病灶边缘情况、病变区周围腺体结构）均在良恶性鉴别存在显著性差异（P<0.05）。ROC曲线分析发现，3种检查方式曲线下面积均大于0.5，均具有乳腺疾病诊断价值。3种检查方法，数字乳腺断层摄影敏感度 （ 67.5%）大于全数字化乳腺摄影（ 62.2%）及彩超（61.9%），特异性数字乳腺断层摄影均高于其他两者。 结论数字乳腺断层摄影相对于全数字化乳腺摄影、彩超能更好地观察结构扭曲病变，提高诊断效能。 Abstract:ObjectiveTo study the comparative study of mammography (full digital mammography FFDM, digital mammography DBT) and ultrasonography on benign and malignant structural distortion and its X-ray sign analysis. MethodsCollecting 51 patients, with the age from 20 to 70 years old (average 44.84±8.738) , who underwent FFDM, DBT and color Doppler ultrasound examinations from June 2013 to December 2018 and found signs of structural distortion and pathological findings. According to the mammography report and data system, the diagnostic diagnosis and the analysis of the signs of structural distortion of the three imaging methods were compared. ResultsFisher's precise algorithm was used to analyze the X-ray signs of structural distortion, which had significant difference between benign and malignant (P<0.05). The diagnostic efficiency of three methods in breast diseases was analyzed by ROC curve. The study found that the area under the curve were greater than 0.5, is a valuable diagnostic sensitivity. ConclusionCompared with FFDM,and US, DBT can better observe the structural distortion and improve the diagnostic efficacy. -
图 1 44岁女性，DBT上发现结构扭曲，FFDM和彩超的影像表现（良）
A: FFDM乳腺病灶（方框内）；B: DBT乳腺病灶（方框内）；C: 彩超乳腺图像
Figure 1. Women patient, 44 years old, DBT with structural distortion, FFDM and color Doppler imaging findings (good)
图 2 44岁女性，DBT发现结构扭曲，FFDM和彩超的影像表现（恶）
A: FFDM乳腺病灶（方框内）；B: DBT乳腺病灶（方框内）；C: 彩超乳腺图像
Figure 2. Women, 44 years old, DBT found distorted structures, FFDM and color Doppler imaging findings (malignant)
图 3 结构扭曲中心密度
A: 病灶中心密度为低；B: 病灶中心密度为等；C: 病灶中心密度为高
Figure 3. Structural distortion center density
图 4 结构扭曲边缘情况
A: 病灶边缘浸润破坏；B: 病灶边缘放射星芒状；C: 病灶边缘模糊不清
Figure 4. Structural distortion of edges
图 6 FFDM、DBT、彩超诊断效能（单纯结构扭曲）
Figure 6. Diagnostic efficacy of FFDM、DBT、 color ultrasound (simple structural distortion)
表 1 乳腺X线各征象分析
Table 1. Analysis of signs of breast X line
Sign Benign（n） malignant（n） P Center density <0.01 LOW 19 2 Equal 9 8 High 13 Marginal situation <0.01 Infiltration 12 14 Stellate 1 6 Vague 15 3 Lesion area structure <0.01 Disappear 11 22 Visible 17 1 
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