| 梁兴明,黄世海,汪轶亭,孔小丽,孙劲松.钼靶X射线与彩色多普勒超声对乳腺癌的影像学特征及诊断价值比较分析[J].,2022,(17):3319-3323 |
| 钼靶X射线与彩色多普勒超声对乳腺癌的影像学特征及诊断价值比较分析 |
| Comparative Analysis of Imaging Features and Diagnostic Value of Molybdenum Target X-ray and Color Doppler Ultrasound in Breast Bancer |
| 投稿时间：2022-03-10 修订日期：2022-04-05 |
| DOI：10.13241/j.cnki.pmb.2022.17.023 |
| 中文关键词: 乳腺癌 钼靶X射线 彩色多普勒超声技术 影像学 特征 诊断价值 |
| 英文关键词: Breast cancer Molybdenum target X-ray Color Doppler ultrasound Imaging Features Diagnostic value |
| 基金项目:安徽省卫生健康委科研项目（AHWJ2020A1631） |
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| 摘要 目的：探讨乳腺癌患者钼靶X射线与彩色多普勒超声（CDUs）的影像学特征及联合应用的诊断价值。方法：前瞻性选取 2018年1月至2021年6月收入安徽医科大学附属巢湖医院且疑似为乳腺癌患者120例，所有患者均接受钼靶X射线与CDUs技术检查，以手术病理为金标准，分别观察钼靶X射线与CDUs对不同大小乳腺癌的诊断价值、比较乳腺癌钼靶X射线与CDUs的影像特征，探讨钼靶X射线及CDUs单独应用及联合应用的诊断效能。结果：120例患者确诊乳腺癌者106例，证实为良性病变者14例。对于不同直径的乳腺癌诊断比较中，CDUs检查直径<1 cm病灶31个（29.25%），钼靶X射线检查直径<1 cm病灶23个（21.70%），组间比较具有统计学差异（P<0.05）；对于直径>3 cm病灶，钼靶X射线检查22个（20.75%），CDUs检查为14个（13.21%），组间比较具有统计学差异（P<0.05）。乳腺癌钼靶X射线与CDUs的影像特征比较显示，钼靶X射线对于点状微小钙化检查72个（67.92%）、边缘模糊伴毛刺病灶检查84个（79.25%），二者征象检出率明显高于CDUs检查40个（37.36%）、47个（44.34%），组间比较具有统计学差异（P<0.05）；CDUs对于肿块影检查个（76.42%）、增粗血管影或血流信号异常病灶检查79个（74.53%），二者征象检出率明显高于钼靶X射线检查54（50.94%）个、57（53.77%）个，组间比较具有统计学差异（P<0.05）。钼靶X射线及CDUs诊断效能研究显示钼靶X射线联合CDUs技术检查的敏感度、特异度、准确度、阴性预测值（NPV）以及阳性预测值（PPV）分别为93.40%、93.41%、95.83%、64.29%及76.98%，均高于钼靶X射线的83.02%、88.89%、80.19%、15.81%及51.88%，亦高于CDUs技术的78.30%、75.47%、85.83%、28.57%及30.98%，多组数据单因素方差分析具有统计学差异（P<0.05）。结论：钼靶X射线与CDUs技术在诊断乳腺癌方面各有优缺点，二者联合检查利于提升对乳腺癌的诊断准确性，减少误诊漏诊的情况发生。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the imaging features of Molybdenum target X-ray and color Doppler ultrasound (CDUs) in breast cancer patients and the diagnostic value of their combined application. Methods: 120 patients with suspected breast cancer who were admitted to Chaohu Hospital Affiliated to Anhui Medical University from January 2018 to June 2021 were prospectively selected. All patients were examined by Molybdenum target X-ray and CDUs. The diagnostic value of Molybdenum target X-ray and CDUs in breast cancer of different sizes, compare the imaging characteristics of Molybdenum target X-ray and CDUs in breast cancer, and discuss the diagnostic efficacy of Molybdenum target X-ray and CDUs alone and in combination. Results: 120 patients diagnosed 106 cases of breast cancer, 14 cases were confirmed as benign lesions.For the diagnosis of breast cancer with different diameters, CDUs detected 31 (29.25%) diameter <1 cm lesions, and molybdenum target X-ray detected diameter <1 cm lesions 23 (21.70%), and there was a significant difference between the groups (P<0.05). For lesions with a diameter of >3 cm, 22 (20.75%) were detected by molybdenum target X-ray and 14 (13.21%) by CDUs, which was significant difference between the groups (P<0.05). The comparison of imaging characteristics between molybdenum target X-ray and CDUs in breast cancer shows that, molybdenum target X-ray for punctate microcalcification detection 72 (67.92%), edge fuzzy with burr lesions detection 84 (79.25%), two signs detection rate was significantly higher than CDUs detection 40 (37.36%), 47 (44.34%), there was a significant difference between the groups (P<0.05). CDUs detected 79 (74.53%) lesions with mass shadow (76.42%) and thickened vascular shadow or abnormal blood flow signal, the detection rate of the two signs was significantly higher than that of 54 (50.94%) and 57 (53.77%) detected by molybdenum target X-ray(P<0.05). The diagnostic efficacy study of molybdenum target X-ray and CDUS showed that the sensitivity, specificity, accuracy, negative predictive value(NPV) and positive predictive value(PPV) of molybdenum target X-ray combined with CDUs technology were 93.40%, 93.41%, 95.83%, 64.29% and 76.98% respectively, which were higher than 83.02%, 88.89%, 80.19%, 15.81% and 51.88% of molybdenum target X-ray and 78.30%, 75.47%, 85.83%, 28.57% and 30.98% of CDUs technology, there was significant difference among groups by one-way ANOVA (P<0.05). Conclusion: Molybdenum target X-ray and CDUS have their own advantages and disadvantages in the diagnosis of breast cancer. The combined examination of molybdenum target X-ray and CDUS can improve the diagnostic accuracy of breast cancer and reduce the occurrence of misdiagnosis and missed diagnosis. |
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