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计算机辅助诊断技术可提高肿块最大径≤10 mm早期乳腺癌的超声诊断效能

赵枫 肖际东 文欢 贺芳

赵枫, 肖际东, 文欢, 贺芳. 计算机辅助诊断技术可提高肿块最大径≤10 mm早期乳腺癌的超声诊断效能[J]. 分子影像学杂志, 2021, 44(2): 226-231. doi: 10.12122/j.issn.1674-4500.2021.02.03
引用本文: 赵枫, 肖际东, 文欢, 贺芳. 计算机辅助诊断技术可提高肿块最大径≤10 mm早期乳腺癌的超声诊断效能[J]. 分子影像学杂志, 2021, 44(2): 226-231. doi: 10.12122/j.issn.1674-4500.2021.02.03
Feng ZHAO, Jidong XIAO, Huan WEN, Fang HE. Application of computer-aided ultrasonography in assisting radiologists to diagnose early breast cance[J]. Journal of Molecular Imaging, 2021, 44(2): 226-231. doi: 10.12122/j.issn.1674-4500.2021.02.03
Citation: Feng ZHAO, Jidong XIAO, Huan WEN, Fang HE. Application of computer-aided ultrasonography in assisting radiologists to diagnose early breast cance[J]. Journal of Molecular Imaging, 2021, 44(2): 226-231. doi: 10.12122/j.issn.1674-4500.2021.02.03

计算机辅助诊断技术可提高肿块最大径≤10 mm早期乳腺癌的超声诊断效能

doi: 10.12122/j.issn.1674-4500.2021.02.03
基金项目: 

湖南省卫生计生委科研课题 B2019177

湖南省自然科学基金 2019JJ40459

详细信息
    作者简介:

    赵枫,在读硕士研究生,E-mail: 188312105@csu.edu.cn

    通讯作者:

    肖际东,博士,副主任医师,E-mail: jidongxiao1975@126.com

Application of computer-aided ultrasonography in assisting radiologists to diagnose early breast cance

  • 摘要: 目的探讨计算机辅助诊断在早期乳腺癌诊断中的价值。方法对120枚病理证实的最大径≤20 mm乳腺肿块(乳腺癌结节50枚,良性结节70枚)超声图像进行回顾性分析,根据肿块大小分为最大径≤10 mm组(56枚)、最大径11~20 mm组(64枚)两组,由2名超声医师参照BI-RADS-US分类予以诊断,结合计算机超声辅助诊断结果后再次诊断,以病理结果为金标准,对比分析计算机辅助诊断在超声诊断早期乳腺癌中的作用。结果乳腺肿块最大径≤10 mm组中,应用普通超声对早期乳腺癌的敏感性、特异性和准确性分别为62.5%、59.4%、60.7%,操作性曲线下面积(AUC)为0.61。结合计算机辅助诊断技术结果为79.2%、81.3%、80.4%;AUC为0.80。对于最大径11~20 mm组,常规超声的敏感性、特异性和准确性分别为69.2%、68.4%、68.8%,ROC曲线AUC为0.69。结合计算机辅助诊断结果为80.8%、81.6%、81.3%;AUC为0.81。计算机辅助诊断后两组不同大小乳腺肿块的敏感性、特异性、准确性及AUC均有提高,乳腺肿块最大径≤10 mm组的准确率及AUC提高尤为显著,差异有统计学意义(P < 0.05)。结论计算机辅助诊断技术有助于提高早期乳腺癌的超声诊断效能,尤其是辅助最大径≤10 mm的早期乳腺癌的诊断。

     

  • 图  1  患者女,56岁,右侧乳腺一8 mm×6 mm实性肿块;第1次常规诊断为良性(BI-RADS 3类),第2次结合计算机辅助诊断后诊断为恶性(BI-RADS 4b类)

    A: 肿块矢状切面超声图像; B: 肿块矢状切面对应的横切面超声图像; C: 肿块矢状切面超声图像经S-detect技术分析得出的诊断结论(可能恶性); D: 肿块矢状切面对应的横切面超声图像经S-detect技术分析得出的诊断结论(可能恶性); E: 病理HE染色(×200)乳腺浸润性导管癌.

    Figure  1.  The patient was a 56-year-old woman with a mass in the right breast. The breast mass size is 8 mm × 6 mm. The US diagnose of the breast mass by the radiologist was benign(BI-RADS 3), and after the combination of US and computer-aided diagnosis technology, the diagnose was modified to malignant (BI-RADS 4b).

    图  2  CAD辅助前后诊断乳腺肿块最大径≤10 mm组(A)及最大径11~20 mm组(B)ROC曲线

    Figure  2.  ROC curves of diagnosis in maximum diameter ≤10 mm breast masses group (A) and maximum diameter 11-20 mm breast masses group (B) with CAD assisted US.

    表  1  两组不同大小乳腺肿块的超声表现

    Table  1.   Ultrasonic features of breast masses with different size in two groups (n)

    分组 形态 方向 边缘 边界 后方回声 周围组织 微钙化
    规则 不规则 平行位 非平行位 光整 欠光整 清晰 欠清晰 有声影 无声影或增强 正常 受牵拉变形
    最大直径≤10 mm
      良性 19 13 27 5 19 13 24 8 3 29 30 2 4 28
      恶性 14 10 17 7 4 20 9 15 7 17 16 8 11 13
    最大直径11~20 mm
      良性 25 13 30 8 22 16 32 6 4 32 36 2 7 31
      恶性 10 16 15 11 3 23 8 18 10 16 10 16 11 15
    下载: 导出CSV

    表  2  超声与计算机辅助诊断不同大小乳腺肿块的结果比较

    Table  2.   The comparison between the diagnosis results of US and computer-aided diagnosis for different size of masses (n)

    分组 最大直径≤10 mm 最大直径为11~20 mm
    恶性 良性 恶性 良性
    普通超声
      恶性 15 13 18 12
      良性 9 19 8 26
    普通超声+S-detect
      恶性 19 6 21 7
      良性 5 26 5 31
    下载: 导出CSV

    表  3  计算机辅助技术辅助前后诊断不同大小肿块的效能比较

    Table  3.   The comparison of diagnostic efficacy in different size breast masses before and after combined with computer-aided technology (%)

    指标 最大直径≤10 mm 最大直径为11~20 mm
    普通超声 普通超声+S-detect P 普通超声 普通超声+S-detect P
    敏感性 62.5 79.2 0.125 69.2 80.8 0.508
    特异性 59.4 81.3 0.016* 68.4 81.6 0.227
    准确性 60.7 80.4 0.001* 68.8 81.3 0.115
    阴性预测值 67.9 83.9 0.006* 76.5 86.0 0.001*
    阳性预测值 53.6 76.0 0.337 60.0 75.0 0.163
    下载: 导出CSV
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  • 收稿日期:  2021-01-12
  • 刊出日期:  2021-03-20

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