自动乳腺全容积成像在乳腺导管原位癌诊断中的应用价值

摘要

ObjectiveTo investigate the value of the automated breast volume scanner (ABVS) in the diagnosis of ductal carcinomain situ(DCIS).MethodsSixty-seven patients who were diagnosed as DCIS by histopathology from December, 2010 to December, 2012 were retrospectively analyzed. Their image results and detection rates of mammography, conventional ultrasound and ABVS were analyzed and compared by Nonparametric Cochran'sQ test, and the further comparison were performed between groups by McNemar test.ResultsThe cases diagnosed as mass (with or without microcalcifications) by mammography, conventional ultrasound and ABVS were 13 (19%), 22 (33%) and 25 (37%), respectively. The detection rates of conventional ultrasound and ABVS were higher than mammography, and the differences were statistically significant (χ2=7.11, 10.08, bothP<0.05). However, the detection rate of mass between conventional ultrasound and ABVS were not statistically different (P>0.05). The cases diagnosed as simple microcalcification or associated with microcalcification by mammography, conventional ultrasound and ABVS were 42 (63%), 30 (45%) and 39 (58%), respectively. The detection rates of simple microcalcification or associated with microcalcifications by mammography and ABVS were higher than conventional ultrasound, and the differences were statistically significant (χ2=8.64, 5.82, bothP<0.05). However, the detection rate of simple microcalcification or associated with microcalcifications between conventional ultrasound and ABVS were not statistically different (P>0.05). The detection rates of DCIS by mammography, conventional ultrasound and ABVS were 84%, 70% and 91%. The detection rates of DCIS by mammography and ABVS were higher than conventional ultrasound, and the differences were statistically significant. But the rate between mammography and ABVS showed no statistical significance.ConclusionsABVS can improve the ultronic detection rate of breast DCIS. Its detection rate is similar with mammography performance.%目的探讨自动乳腺全容积成像（ABVS）在乳腺导管原位癌（DCIS）诊断中的应用价值。方法回顾性分析2010年12月至2012年12月杭州市第一人民医院收治的经手术病理证实的67例乳腺DCIS患者的钼靶X线、常规超声及ABVS表现。钼靶X线、常规超声及ABVS表现，钼靶X线、常规超声及ABVS的乳腺DCIS检出率比较采用非参数Cochran′s Q test比较，进一步组间两两比较采用McNemar test。结果钼靶X线、常规超声及ABVS表现为肿块（伴或不伴微钙化）的乳腺DCIS分别为13例（19%）、22例（33%）、25例（37%），常规超声、ABVS表现为肿块（伴或不伴微钙化）的乳腺DCIS均多于钼靶X线，且差异均有统计学意义（χ2=7.11、10.08，P均＜0.05），而常规超声与ABVS表现为肿块（伴或不伴微钙化）的乳腺DCIS差异均无统计学意义。钼靶X线、常规超声及ABVS表现为单纯或伴发微钙化的乳腺DCIS分别为42例（63%）、30例（45%）、39例（58%），钼靶X线、ABVS表现为单纯或伴发微钙化的乳腺DCIS均多于常规超声，且差异均有统计学意义（χ2=8.64、5.82，P均＜0.05），而钼靶X线与ABVS表现为单纯或伴发微钙化的乳腺DCIS差异均无统计学意义。钼靶X线、常规超声及ABVS的乳腺DCIS检出率分别为84%、70%及91%，钼靶X线、ABVS的乳腺DCIS检出率均高于常规超声，且差异均有统计学意义（χ2=4.92、9.39，P均＜0.05），但ABVS与钼靶X线的乳腺DCIS检出率差异无统计学意义。结论 ABVS能提高超声对乳腺DCIS的检出率，与钼靶X线诊断效能相仿。