乳腺专用伽玛显像仪对乳腺癌的诊断价值

摘要

Objective To compare the efficiency of breast specific gamma imaging (BSGI) and mammography for the diagnosis of breast carcinoma.Methods Fifty-six patients suspected of breast carcinoma underwent both BSGI and mammography within 15 d interval before surgery,and the diagnostic results were verified with histological examination.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were calculated.x2 test was applied for statistical analysis.Results The sensitivity,specificity,accuracy,positive predictive value,negative predictive value of BSGI and mammography were 92％(34/37) vs 76％(28/37),84％(16/19) vs 74％(14/19),89％(50/56) vs 75％(42/56),92％(34/37) vs 85％(28/33),84％(16/19) vs 61％(14/23),respectively,and there was no significant difference between the two methods (x2 =1.14,P＞0.05).There were 6 breast carcinoma patients with dense breast tissue,and those malignant lesions were accurately identified with BSGI,but not with mammography.Conclusion BSGI is a useful adjunct imaging modality for the diagnosis of breast carcinoma,especially for the dense breast.%目的 通过与钼靶成像进行比较,探讨乳腺专用伽玛显像(BSGI)仪诊断乳腺癌的临床价值.方法 56例拟行手术的乳腺肿块女性患者分别进行BSGI和钼靶成像,2次检查间隔不超过15 d.对照术后病理结果,分别计算2种显像方法诊断乳腺癌的灵敏度、特异性、准确性、阳性预测值和阴性预测值,并采用配对x2检验比较检出率差异.结果 BSGI和钼靶成像诊断乳腺癌的灵敏度分别为92％ (34/37)和76％(28/37),特异性分别为84％(16/19)和74％ (14/19),准确性分别为89％ (50/56)和75％(42/56),阳性预测值分别为92％(34/37)和85％ (28/33),阴性预测值分别为84％(16/19)和61％(14/23),但两者诊断效能差异无统计学意义(X2=1.14,P＞0.05).BSGI准确诊断出6例钼靶成像漏诊的乳腺癌,该6例患者的乳腺组织均呈致密型.结论 BSGI对于乳腺癌(尤其是乳腺组织呈致密型者)的诊断具有一定的临床应用价值,弥补了钼靶成像的不足.