| 龙蓉,曹崑,曹敏,李海蛟,孙应实.对比增强能谱乳腺X线摄影诊断乳腺影像报告和数据系统4类钙化[J].中国医学影像技术,2019,35(4):498~502 |
| 对比增强能谱乳腺X线摄影诊断乳腺影像报告和数据系统4类钙化 |
| Diagnostic performance of contrast-enhanced spectral mammography for breast imaging reporting and data system 4 calcifications |
| 投稿时间：2018-11-05 修订日期：2019-01-24 |
| DOI：10.13929/j.1003-3289.201811026 |
| 中文关键词: 乳腺肿瘤 钙化 乳房X线摄影术 对比剂 乳腺影像报告和数据系统 |
| 英文关键词:breast neoplasms calcification mammography contrast media breast imaging reporting and data system |
| 基金项目:北京市医院管理局重点医学专业发展计划（ZYLX201803）、国家重点研发计划"重大慢性非传染性疾病防控研究"专项（2017YFC1309101、2017YFC1309104）、北京市百千万人才工程项目（2017A13）。 |
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| 中文摘要: |
| 目的 对比分析全视野数字化乳腺X线（FFDM）与对比增强能谱乳腺X线摄影（CESM）对乳腺影像报告和数据系统（BI-RADS）4类钙化的诊断价值。方法 收集常规乳腺X线片中以钙化为唯一征象、且诊断报告定为BI-RADS 4类乳腺病变患者，根据检查方式不同分为FFDM组（n=48）和CESM组（n=31）。FFDM根据钙化分布及形态、CESM根据钙化相应处有无强化为依据作出良恶性诊断，以病理结果为金标准，计算并比较FFDM及CESM对恶性钙化的诊断效能。结果 FFDM诊断恶性钙化的敏感度、特异度、阳性预测值、阴性预测值和准确率分别为69.23%（9/13）、77.14%（27/35）、52.94%（9/17）、87.10%（27/31）和75.00%（36/48），CESM组分别为90.00%（9/10）、95.24%（20/21）、90.00%（9/10）、95.24%（20/21）和93.55%（29/31）。CESM诊断恶性钙化的阳性预测值和准确率高于FFDM，差异有统计学意义（χ2=3.891、4.444，P=0.049、0.035）。结论 与FFDM比较，CESM可提高对BI-RADS 4类钙化的诊断效能。 |
| 英文摘要: |
| Objective To assess the diagnostic performance of contrast-enhanced spectral mammography (CESM) for breast imaging reporting and data system (BI-RADS) 4 calcifications comparing with full-field digital mammography (FFDM). Methods Patients with mammographic calcifications without associated mass or distortions, which were originally reported as BI-RADS 4 were enrolled, and the lesions were divided into FFDM group (n=48) or CESM group (n=31) according to the examination they received. The diagnosis of benign or malignant calcifications was made based on distribution and morphology on FFDM and the presence of enhancement on CESM. Taking pathology results as golden standards, the diagnostic efficacy was assessed and compared between FFDM and CESM. Results The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 69.23% (9/13), 77.14% (27/35), 52.94% (9/17), 87.10% (27/31) and 75.00%(36/48) for FFDM group, and 90.00% (9/10), 95.24% (20/21), 90.00% (9/10), 95.24% (20/21) and 93.55% (29/31) for CESM group, respectively. PPV and accuracy of CESM were significantly higher than those of FFDM (χ2=3.891, 4.444, P=0.049, 0.035). Conclusion Compared with FFDM, CESM can improve diagnostic performance on BI-RADS 4 mammographic calcifications. |
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