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中华临床医师杂志(电子版) ›› 2018, Vol. 12 ›› Issue (07) : 377 -382. doi: 10.3877/cma.j.issn.1674-0785.2018.07.002

所属专题: 文献

临床研究

全数字化乳腺X线摄影与超声萤火虫技术对乳腺微钙化检出的比较
张珍珍1, 马彦云2,(), 贾田菊2, 宁艳云2   
  1. 1. 036002 朔州,朔州市朔城区人民医院超声科
    2. 030001 太原,山西医科大学附属第一医院放射科
  • 收稿日期:2018-01-29 出版日期:2018-04-01
  • 通信作者: 马彦云
  • 基金资助:
    山西医科大学大学生创新创业校级项目(20160806); 山西省卫生计生委科研项目(2017042)

Comparison of mammography and MicroPure imaging in detecting breast microcalcification

Zhenzhen Zhang1, Yanyun Ma2,(), Tianju Jia2, Yanyun Ning2   

  1. 1. Department of Ultrasound, the People′s Hospital of Shuocheng District, Shuozhou 036002, China
    2. Department of Radiology, the First Hospital of Shanxi Medical University, Taiyuan 030001, China
  • Received:2018-01-29 Published:2018-04-01
  • Corresponding author: Yanyun Ma
  • About author:
    Corresponding author: Ma Yanyun, Email:
引用本文:

张珍珍, 马彦云, 贾田菊, 宁艳云. 全数字化乳腺X线摄影与超声萤火虫技术对乳腺微钙化检出的比较[J]. 中华临床医师杂志(电子版), 2018, 12(07): 377-382.

Zhenzhen Zhang, Yanyun Ma, Tianju Jia, Yanyun Ning. Comparison of mammography and MicroPure imaging in detecting breast microcalcification[J]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(07): 377-382.

目的

评价超声"萤火虫"技术与全数字化乳腺X线(FFDM)相比在乳腺微钙化检出方面的意义及其临床应用价值。

方法

收集山西医科大学第一医院于2016年11月至2017年11月经手术病理证实的乳腺病变患者126例,将其分为肿块伴钙化组、单纯钙化组、无钙化组(单纯肿块、非肿块无钙化),所有患者于术前均行FFDM及超声"萤火虫"技术检查,比较超声"萤火虫"技术与FFDM对乳腺微钙化的显示情况,并以病理结果为金标准,采用受试者工作特征(ROC)曲线评价2种影像学方法对乳腺微钙化检出的效能,同时采用Z检验比较2种影像学方法的曲线下面积,评价其诊断价值。

结果

(1)超声"萤火虫"成像显示肿块内微钙化的特异度(83%)较FFDM(91%)低,灵敏度(96%)较FFDM(91%)高,2者的ROC曲线下面积分别为0.894、0.909,但2者对肿块内微钙化的诊断价值差异无统计学意义(Z=0.25,P>0.05)。(2)超声"萤火虫"成像显示单纯微钙化的特异度、灵敏度(25%、79%)均较FFDM(87%、91%)低,2者的ROC曲线下面积分别为0.522、0.893,FFDM对单纯微钙化的诊断价值优于超声"萤火虫"成像技术(Z=3.71,P<0.05)。

结论

超声"萤火虫"成像技术对乳腺微钙化检出的特异性不如FFDM,但其对乳腺肿块内微钙化检出的敏感性高,有助于超声科医师判断乳腺病变的良恶性。

Objective

To evaluate the significance and clinical application of MicroPure imaging in the detection of breast microcalcification by comparing with full-field digital mammography (FFDM).

Methods

We selected 126 breast lesions confirmed by surgical pathology at the First Hospital of Shanxi Medical University from November 2016 to November 2017. The lesions were divided into a tumor with calcification group, a simple calcification group, and a no calcification group (simple lumps and non-lumps without calcification). All patients underwent FFDM and MicroPure imaging before surgery, and the accuracy of detection of breast microcalcification by FFDM and MicroPure was compared. Using pathological results as the gold standard, ROC curve was plotted to evaluate the efficiency of the two imaging methods in detecting breast microcalcification. The Z test was used to compare whether the areas under the curves of the two imaging methods had a difference.

Results

The specificity of MicroPure in detecting microcalcification in the mass was lower than that of FFDM (83% vs 91%), while the sensitivity was higher than that of FFDM (96% vs 91%). The areas under the ROC curves were 0.894 and 0.909, respectively, and they had equivalent diagnostic value for microcalcification in the mass (Z=0.25, P>0.05). The specificity and sensitivity of MicroPure imaging in detecting simple microcalcification were lower than those of FFDM (25% vs 87%; 79% vs 91%), and the areas under the ROC curves were 0.522 and 0.893, respectively, which suggested that FFDM had better diagnostic value compared with Micropure imaging for simple microcalcification (Z=3.71, P<0.05).

Conclusion

MicroPure imaging has a low specificity than FFDM in detecting breast microcalcification, but it has a high sensitivity in detecting microcalcification in breast masses, which is helpful for ultrasound doctors to distinguish benign and malignant breast lesions.

表1 126例乳腺病患者手术病理结果(例)
表2 超声"萤火虫"技术与FFDM技术检出肿块内微钙化的情况
图1 超声"萤火虫"技术与全数字化乳腺X线摄影对肿块内微钙化检出的ROC曲线
表3 超声"萤火虫"技术与FFDM技术检出单纯微钙化的情况
图2 超声"萤火虫"技术与全数字化乳腺X线摄影对单纯微钙化检出的ROC曲线
图3 全数字化乳腺X线摄影显示为粗糙不均质微钙化 图3a、3c示左乳外下象限簇状分布的粗糙不均质钙化,图3b、3d分别为a、c图的局部放大
图5 病理证实左乳浸润性导管癌,其内可见钙化(HE染色,×100)
图6 全数字化乳腺X线摄影显示微钙化为区域分布 图6a、6c示左乳外上象限区域分布的粗糙不均质钙化,图6b、6d分别为a、c图的局部放大
图8 病理证实右乳浸润性导管癌,其内可见钙化(HE染色,×100)
1
Hartmann LC, Degnim AC, Santen RJ, et al. Atypical hyperplasia of the breast--risk assessment and management options [J]. N Engl J Med, 2015, 372(1):78-89.
2
Bundred SM, Zhou J, Whiteside S, et al. Impact of full-field digital mammography on pre-operative diagnosisand surgical treatment of mammographic microcalcification [J]. Breast Cancer Res Treat, 2014, 143(2):359-366.
3
Svahn TM, Houssami N, Sechopoulos I, et al. Review of radiation dose estimates in digital breast tomosynthesis relative to those in two-view full-field digital mammography [J]. Breast, 2015, 24(2):93-99.
4
DeSantis CE, Fedewa SA, Goding Sauer A, et al. Breast cancer statistics, 2015: Convergence of incidence rates between black and white women [J]. CA Cancer J Clin, 2016, 66(1):31-42.
5
Vaughan CL, Douglas TS, Said-Hartley Q, et al. Testing a dualmodality system that combines full-field digital mammography and automated breast ultrasound [J]. Clin Imaging, 2016, 40(3):498-505.
6
Gufler H, Buitrago-Relleyez CH, Madjar H, et al. Ultrasound demonstration of mammographically detected microcalcifications [J]. Acta Radiol, 2000, 41(3):217-221.
7
张珍珍,马彦云,贾田菊, 等. 乳腺微钙化研究的新进展 [J]. 中国农村卫生, 2017, 20(122):9-10.
8
Machado P, Eisenbrey JR, Cavanaugh B, et al. Evaluation of a new image processing technique for the identification of breast Microcalcifications [J]. Ultrasound in Medicine and Biology, 2013, 39(5):S87.
9
韩秀婕,任俊红,马娜, 等. 早期乳腺癌微钙化的超声检测价值及其与病理相关性分析 [J]. 中华医学杂志, 2012, 92(33):2349-2352.
10
王海英,张伟华,李乐平, 等. X线钼靶摄影与超声诊断乳腺微钙化灶的对比研究 [J]. 中国现代普通外科进展, 2008, 11(5):376-379.
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