| 陈军,袁萱,李越,杨光,华蓓,葛金丹,赵丹丹.对比增强乳腺摄影鉴别乳腺良、恶性钙化性病变[J].中国医学影像技术,2024,40(11):1688~1692 |
| 对比增强乳腺摄影鉴别乳腺良、恶性钙化性病变 |
| Contrast-enhancement mammography for differentiating benign and malignant breast lesions with calcifications |
| 投稿时间：2024-03-13 修订日期：2024-06-20 |
| DOI：10.13929/j.issn.1003-3289.2024.11.012 |
| 中文关键词: 乳腺肿瘤 钙质沉着症 乳腺X线摄影 对比剂 |
| 英文关键词:breast neoplasms calcinosis mammography contrast media |
| 基金项目:河北省医学科学研究重点科技研究计划(20230897、20242016)。 |
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| 中文摘要: |
| 目的 观察对比增强乳腺摄影(CEM)鉴别乳腺良、恶性钙化性病变的价值。方法 回顾性纳入116例女性患者、共132处乳腺影像报告和数据系统(BI-RADS)乳腺X线摄影4~5类钙化性病变,依病理学结果将其分为恶性组(n=86)与良性组(n=46);根据钙化形态及其分布特征将其分为高风险与低风险,由此获得钙化总体风险分型,联合有无伴随强化进行CEM总体风险分型。采用受试者工作特征(ROC)曲线及其曲线下面积(AUC)评估上述各参数鉴别乳腺良、恶性钙化性病变的效能并进行间比较。结果 组间钙化形态、分布和有无伴随强化差异均有统计学意义(P均＜0.05)。以钙化形态风险、钙化分布风险、钙化总体风险、钙化伴随强化,以及CEM总体风险鉴别乳腺良、恶性钙化性病变的AUC分别为0.709、0.678、0.774、0.800及0.875,CEM总体风险的效能高于其他(P均＜0.05)。结论 联合钙化形态、分布及有无伴随强化等特征进行CEM总体风险分型可提高CEM鉴别乳腺良、恶性钙化性病变的效能。 |
| 英文摘要: |
| Objective To observe the value of contrast-enhanced mammography (CEM) for differentiating benign and malignant breast lesions with calcifications. Methods Data of 116 female patients with 132 breast imaging reporting and data system (BI-RADS) category 4 to 5 lesions were retrospectively analyzed. The lesions were divided into malignant group (n=86) and benign group (n=46) according to the pathologic results. The morphological manifestations of calcification and their distributions were classified into high or low risk, and the combined risk typing of calcifications was assessed according to these two. Finally, an overall risk typing of CEM was obtained through combining the combined risk type of calcifications and accompanied enhancement or not. Then receiver operating characteristic (ROC) curves were drawn, the area under the curves (AUC) were calculated, and the efficacy of the above indexes for differentiating benign and malignant breast lesions with calcifications were evaluated and compared. Results Significant differences of morphology, distribution and accompanied enhancement were found between groups (all P＜0.05). The AUC of morphology risk, distribution risk, the combined risk of calcification, accompanied enhancement and CEM overall risk for differentiating benign and malignant breast lesions with calcifications was 0.709, 0.678, 0.774, 0.800 and 0.875, respectively, of CEM overall risk was higher than that of the others (all P＜0.05). Conclusion CEM overall risk type obtained through integrating morphology and distribution manifestations of calcifications and enhancement type could improve the efficiency of CEM for differentiating benign and malignant breast lesions with calcifications. |
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