作　　者： ; ; ;

机构地区： 广州医科大学

出　　处： 《西部医学》 2019年第11期1767-1771,共5页

摘　　要： 目的探讨自动乳腺全容积扫描(ABVS)联合动态增强扫描MRI(DCE-MRI)诊断乳腺肿物的价值。方法选择2016年7月~2018年1月广州医科大学附属第二医院女性患者158例,病理检查肿物428个,其中ABVS检查416个,DCE-MRI检查169个,ABVS和DCE-MRI都进行检查有160个。以病理检查结果为"金标准",计算ABVS、DCE-MRI、联合诊断的灵敏度、特异度、准确度、阳性预测值和阴性预测值。不同诊断方法与病理检查一致性的比较采用Kappa检验。结果 ABVS与病理诊断的kappa值为0.464,DCE-MRI为0.848,ABVS联合DCE-MRI(任意恶判为恶)为0.581,ABVS联合DCE-MRI(任意良判为良)为0.750,ABVS联合DCE-MRI(舍弃两种判断不一致的肿物)为0.915。ABVS诊断乳腺癌的灵敏度和特异度分别为66.67%和93.32%;DCE-MRI为94.12%和97.37%;ABVS联合DCE-MRI(任意诊断为恶性则判断为恶性)为100.00%和96.71%;ABVS联合DCE-MRI(任意诊断为良性则判断为良性)为70.59%和98.60%;ABVS联合DCE-MRI(舍弃两种判断不一致的肿物)为100.00%和98.41%。结论 ABVS联合DCE-MRI可提高以"任意诊断为恶性则判断为恶性"为乳腺癌诊断依据的诊断灵敏度,也可提高以"任意诊断为良性则判断为良性"为乳腺癌诊断依据的诊断特异度。在"舍弃两种判断不一致的肿物"的条件下,ABVS联合DCE-MRI可同时提高乳腺癌诊断的灵敏度与特异度。 Objective To explore the value of automatic breast volume scanning(ABVS) combined with dynamic contrast-enhanced scanning magnetic resonance imaging(DCE-MRI) in the diagnosis of breast tumors.Methods From July 2016 to January 2018, 158 female patients in our hospital, 428 tumors in pathological examination were included in the present study. 416 of them were examined by ABVS and 169 by DCE-MRI and 160 by ABVS and DCE-MRI. The sensitivity, specificity, positive predictive value and negative predictive value of ABVS, DCE-MRI and combined diagnosis were calculated according to the "gold standard" of pathological examination results. Kappa test was used to compare the consistency of different diagnostic methods and pathological examination. Results The kappa value of ABVS and pathological diagnosis was 0.464(0.315, 0.613), DCE-MRI was 0.848(0.719, 0.978), ABVS combined with DCE-MRI was 0.581(0.421, 0.742), ABVS combined with DCE-MRI was 0.750(0.574, 0.927), ABVS combined with DCE-MRI was 0.915(0.799, 1.000). The sensitivity and specificity of ABVS in the diagnosis of breast cancer were 66.67% and 93.32%, respectively;DCE-MRI was 94.12% and 97.37%. ABVS combined with DCE-MRI(malignancy was judged as malignancy at random) was 100.00% and 96.71%;ABVS combined with DCE-MRI(benign was judged as benign at random) was 70.59% and 98.60%;ABVS combined with DCE-MRI(discarding the tumors with inconsistent judgement) was 100.100% and 98.41%.Conclusion ABVS combined with DCE-MRI can improve the diagnostic sensitivity of breast cancer based on "any diagnosis as malignant", but also can improve the diagnostic specificity of breast cancer based on "any diagnosis as benign". ABVS combined with DCE-MRI can improve the sensitivity and specificity of breast cancer diagnosis at the same time.

关 键 词： 自动乳腺全容积扫描 动态增强核磁共振成像 乳腺癌 诊断效能

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