Diagnosis of breast lesions by molybdenum target combined with ultrasonography
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摘要:
目的 研究钼靶结合超声检查对乳腺病变的诊断效能，为提高临床诊断率提供参考。 方法 选取2018年5月—2021年4月浙江大学医学院附属金华医院收治的150例乳腺病变患者，均经手术病理证实，其中恶性病变53例，良性病变97例；所有患者术前均行钼靶结合超声检查，分析并比较钼靶、超声单项检查与结合检查对乳腺病变诊断的准确率，以手术病理结果为准，评价钼靶、超声单项检查与结合检查对乳腺病变的诊断效能。 结果 钼靶结合超声检查的准确率为95.33%，高于钼靶检查(78.00%)与超声检查(81.33%，均P＜0.05)；钼靶检查对乳腺病变诊断的敏感度、特异度、阳性预测值、阴性预测值分别为86.79%、73.20%、63.89%、91.03%，超声检查分别为90.57%、76.29%、67.61%、93.67%，钼靶结合超声检查分别为98.11%、94.85%、91.23%、98.92%，钼靶结合超声检查对乳腺病变诊断的特异度、阳性预测值、阴性预测值均高于钼靶检查(均P＜0.05)，钼靶结合超声检查对乳腺病变诊断的特异度、阳性预测值均高于超声检查(均P＜0.05)。 结论 钼靶结合超声检查对乳腺病变的诊断效能较好，准确率、特异度及阳性预测值均高于单项检查。 Abstract:Objective To study the diagnostic efficacy of molybdenum target combined with ultrasonography in breast lesions and to provide reference for improving the clinical diagnostic rate. Methods A total of 150 patients with breast lesions treated in Jinhua Hospital Affiliated to Medical College of Zhejiang University from May 2018 to April 2021 were confirmed by surgery and pathology, including 53 cases of malignant lesions and 97 cases of benign lesions. All patients underwent molybdenum target combined with ultrasound before operation. The accuracy of molybdenum target, single ultrasonic examination and combined examination in the diagnosis of breast lesions was analysed and compared. The diagnostic efficacy of molybdenum target, single ultrasonic examination and combined examination in the diagnosis of breast lesions was evaluated on the basis of the surgical and pathological results. Results The accuracy rate of molybdenum target combined with ultrasound was 95.33%, which was higher than that of molybdenum target and ultrasound alone (78.00% and 81.33%, respectively, all P < 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of molybdenum target examination in the diagnosis of breast lesions were 86.79%, 73.20%, 63.89% and 91.03% respectively, those of Ultrasonic examination were 90.57%, 76.29%, 67.61% and 93.67% respectively, and those of molybdenum target combined with ultrasound were 98.11%, 94.85%, 91.23% and 98.92% respectively. The specificity, the positive predictive value and negative predictive value of molybdenum target combined with ultrasound in the diagnosis of breast lesions were higher than those of molybdenum target (all P < 0.05), and the specificity and positive predictive value of molybdenum target combined with ultrasound in the diagnosis of breast lesions were higher than those of ultrasound (all P < 0.05). Conclusion Molybdenum target combined with ultrasonography has better diagnostic efficiency for breast lesions, and the accuracy, specificity and positive predictive value are higher than those of single examination. -
Key words:
- Molybdenum target /
- Ultrasound /
- Breast lesions /
- Diagnostic efficiency
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表 1 钼靶、超声单项检查与结合检查对乳腺病变诊断的准确率比较
Table 1. Comparison of accuracy of molybdenum target, single ultrasonic examination and combined examination in the diagnosis of breast lesions
检查方法 例数 准确(例) 误诊(例) 漏诊(例) 准确率(%) 钼靶检查 150 117 19 14 78.00 超声检查 150 122 17 11 81.33 钼靶结合超声检查 150 143 5 2 95.33ab 注：与钼靶检查比较，χ2=14.264，aP＜0.001；与超声检查比较，χ2=19.500，bP＜0.001。 
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表 2 钼靶、超声单项检查与结合检查对乳腺病变的诊断与手术病理结果比较(例)
Table 2. Comparison of diagnosis and surgical pathological results of breast lesions by molybdenum target, single ultrasonic examination and combined examination (cases)
病理结果 钼靶检查 超声检查 钼靶结合超声检查 合计 恶性 良性 恶性 良性 恶性 良性 恶性 46 7 48 5 52 1 53 良性 26 71 23 74 5 92 97 合计 72 78 71 79 57 93 150
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表 3 钼靶、超声单项检查与结合检查对乳腺病变的诊断效能比较(%)
Table 3. Comparison of diagnostic efficacy of single and combined mammography and ultrasonography in breast lesions (%)
检查方法 灵敏度 特异度 阳性预测值 阴性预测值 钼靶检查 86.79(46/53) 73.20(71/97) 63.89(46/72) 91.03(71/78) 超声检查 90.57(48/53) 76.29(74/97) 67.61(48/71) 93.67(74/79) 钼靶结合超声检查 98.11(52/53)a 94.85(92/97)bc 91.23(52/57)de 98.92(92/93)f 注：与钼靶检查比较，χ2=3.380，aP=0.066；χ2=16.931，bP < 0.001；χ2=13.025，dP＜0.001；χ2=4.296，fP=0.015；与超声检查比较，χ2=13.523，cP < 0.001；χ2=10.324，eP=0.001。
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[1] 张振, 冯云, 李振宇, 等. 多模态MRI联合不同影像学方法对乳腺良、恶性病变的鉴别诊断价值[J]. 中国CT和MRI杂志, 2018, 16(4): 90-93. doi: 10.3969/j.issn.1672-5131.2018.04.028ZHANG Z, FENG Y, LI Z Y, et al. Value of multimodal MRI combined with different imaging methods in differential diagnosis of benign and malignant breast lesions[J]. Chin J CT & MRI, 2018, 16(4): 90-93. doi: 10.3969/j.issn.1672-5131.2018.04.028 [2] 王俊芳, 余小琴, 陈金华. 彩色多普勒超声、钼靶X线摄影与磁共振成像(MRI)在触诊阴性乳腺癌诊断中的应用价值对比分析[J]. 现代医用影像学, 2020, 29(7): 1310-1312. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYY202007040.htmWANG J F, YU X Q, CHEN J H. Comparative analysis of the application value of color Doppler ultrasound, molybdenum target radiography and magnetic resonance imaging (MRI) in the diagnosis of palpation negative breast cancer[J]. Mod Med Imag, 2020, 29(7): 1310-1312. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYY202007040.htm [3] 张晶晶, 高润芳, 王嘉伟, 等. 联合应用高频超声、X线钼靶对触诊阴性乳腺癌的诊断价值[J]. 山西职工医学院学报, 2019, 29(4): 60-62. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZG201904029.htmZHANG J J, GAO R F, WANG J W, et al. Diagnostic value of combined application of high frequency ultrasound and X-ray molybdenum target in palpation negative breast cancer[J]. J Shanxi Staff Med Coll, 2019, 29(4): 60-62. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZG201904029.htm [4] 柏燕, 张凯钟, 张茜. 乳腺钼靶联合超声鉴别诊断早期微钙化乳腺良恶性病变的诊断价值[J]. 现代诊断与治疗, 2017, 28(12): 2270-2271. doi: 10.3969/j.issn.1001-8174.2017.12.070BAI Y, ZHANG K Z, ZHANG X. Diagnostic value of breast molybdenum target combined with ultrasound in differential diagnosis of benign and malignant breast lesions with early microcalcification[J]. Mod Diagn & Treatm, 2017, 28(12): 2270-2271. doi: 10.3969/j.issn.1001-8174.2017.12.070 [5] 梁敏群, 卜庆丰, 张杰, 等. 钼靶X线、超声及MRI联合诊断早期乳腺癌的临床价值[J]. 现代医用影像学, 2017, 26(2): 354-356. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYY201702052.htmLIANG M Q, BU Q F, ZHANG J, et al. Clinical value of molybdenum target X-ray, ultrasound and MRI in the diagnosis of early breast cancer[J]. Mod Med Imag, 2017, 26(2): 354-356. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYY201702052.htm [6] 孔琳琳, 魏小星. 乳腺三维超声成像联合钼靶X线摄影检查对乳腺病变良恶性的鉴别诊断价值[J]. 实用医学影像杂志, 2020, 21(5): 557-558. https://www.cnki.com.cn/Article/CJFDTOTAL-SYXY202005052.htmKONG L L, WEI X X. Value of breast three-dimensional ultrasound imaging combined with molybdenum target radiography in differential diagnosis of benign and malignant breast lesions[J]. J Pract Med Imag, 2020, 21(5): 557-558. https://www.cnki.com.cn/Article/CJFDTOTAL-SYXY202005052.htm [7] 刘巧珍, 唐英杰, 崔志利, 等. 高频超声与钼靶X线诊断不同分期乳腺癌的临床价值[J]. 中国妇幼保健, 2018, 33(17): 4062-4064. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201817088.htmLIU Q Z, TANG Y J, CUI Z L, et al. Clinical value of high frequency ultrasound and molybdenum target X-ray in the diagnosis of different stages of breast cancer[J]. China maternal and child health care, 2018, 33(17): 4062-4064. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201817088.htm [8] 闫敏芳, 杜起军, 任路平, 等. 彩色多普勒超声成像联合钼靶X线对早期乳腺癌的诊断意义[J]. 中国妇幼保健, 2018, 33(22): 5273-5275. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201822096.htmYAN M F, DU Q J, REN L P, et al. Diagnostic significance of color Doppler ultrasound imaging combined with molybdenum target X-ray in early breast cancer[J]. China Mat & Child Health Care, 2018, 33 (22): 5273-5275. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201822096.htm [9] 范美红, 夏丽华, 张礼群. 超声检查结合钼靶检查在乳腺癌检查中的比较与联用分析[J]. 影像研究与医学应用, 2017, 1(6): 90-92. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYY201706053.htmFAN M H, XIA L H, ZHANG L Q. Comparison and analysis of ultrasound combined with molybdenum target examination in the examination of breast cancer[J]. Imaging research and medical application, 2017, 1(6): 90-92. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYY201706053.htm [10] 姜海波, 李猛, 仇丽娟. 钼靶X射线与超声诊断乳腺癌的影像学特征分析及联合应用的临床价值[J]. 包头医学院学报, 2017, 33(11): 60-61. https://www.cnki.com.cn/Article/CJFDTOTAL-BTYX201711025.htmJIANG H B, LI M, QIU L J. Analysis of imaging characteristics of molybdenum target X-ray and ultrasound in the diagnosis of breast cancer and the clinical value of combined application[J]. J BaoTou Med Coll, 2017, 33(11): 60-61. https://www.cnki.com.cn/Article/CJFDTOTAL-BTYX201711025.htm [11] 姚霞飞, 周珂, 钱群飞. 彩色多普勒超声联合钼靶X线摄影对乳腺癌的诊断价值[J]. 中国中西医结合影像学杂志, 2017, 15(3): 348-350. doi: 10.3969/j.issn.1672-0512.2017.03.032YAO X F, ZHOU K, QIAN Q F. Diagnostic value of color Doppler ultrasound combined with mammography in breast cancer[J]. Chin J Integr Trad Chin & West Med Imag, 2017, 15(3): 348-350. doi: 10.3969/j.issn.1672-0512.2017.03.032 [12] 吴春燕. 全数字化乳腺钼靶X线摄影和彩色多普勒超声对早期乳腺癌的诊断价值分析[J]. 影像研究与医学应用, 2018, 2(17): 59-60. doi: 10.3969/j.issn.2096-3807.2018.17.037WU C Y. Diagnostic value of full digital mammography and color Doppler ultrasound in early breast cancer[J]. Imag Res & Med Applic, 2018, 2(17): 59-60. doi: 10.3969/j.issn.2096-3807.2018.17.037 [13] 刘海燕, 郑慧. 高频彩色多普勒超声鉴别乳腺良恶性肿瘤: 基于其灰阶声像及血流特征性分析[J]. 中华全科医学, 2019, 17(9): 1551-1553. doi: 10.16766/j.cnki.issn.1674-4152.000995LIU H Y, ZHENG H. Differentiation of benign and malignant breast tumors by high frequency color Doppler ultrasound: Based on the analysis of gray-scale ultrasonography and blood flow characteristics[J]. Chin Gen Med, 2019, 17(9): 1551-1553. doi: 10.16766/j.cnki.issn.1674-4152.000995 [14] 张丽萍. 彩色多普勒超声联合钼靶X射线在乳腺癌早期诊断中的临床价值探讨[J]. 影像研究与医学应用, 2018, 2(13): 81-82. doi: 10.3969/j.issn.2096-3807.2018.13.051ZHANG L P. Clinical value of color Doppler ultrasound combined with molybdenum target X-ray in early diagnosis of breast cancer[J]. Imag Res & Med Appl, 2018, 2(13): 81-82. doi: 10.3969/j.issn.2096-3807.2018.13.051 [15] 刘巧珍, 唐英杰, 崔志利, 等. 160例早期乳腺癌患者高频超声与钼钯X线诊断结果分析[J]. 中国妇幼保健, 2018, 33(7): 1617-1619. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201807060.htmLIU Q Z, TANG Y J, CUI Z L, et al. Analysis of diagnostic results of high frequency ultrasound and molybdenum palladium X-ray in 160 patients with early breast cancer[J]. China Mat & Child Health Care, 2018, 33(7): 1617-1619. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201807060.htm [16] 胡国鹏. MRI, CT与乳腺X线钼靶摄影诊断乳腺疾病的价值比较[J]. 影像研究与医学应用, 2021, 5(5): 16-17. doi: 10.3969/j.issn.2096-3807.2021.05.008HU G P. Comparison of MRI, CT and mammography in the diagnosis of breast diseases[J]. Imag Res & Med Applic, 2021, 5(5): 16-17. doi: 10.3969/j.issn.2096-3807.2021.05.008 [17] 仇小路, 马晓丽. 乳腺钼靶联合超声鉴别诊断早期微钙化乳腺良恶性病变的诊断效果分析[J]. 现代医用影像学, 2020, 29(1): 109-111. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYY202001045.htmQIU X D, MA X L. Analysis of diagnostic effect of breast molybdenum target combined with ultrasound in differential diagnosis of benign and malignant breast lesions with early microcalcification[J]. Mod Med Imag, 2020, 29(1): 109-111. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYY202001045.htm [18] 张艳君. 彩色多普勒超声联合X线钼靶在乳腺良恶肿瘤诊断中的应用效果分析[J]. 山西职工医学院学报, 2019, 29(2): 55-57. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZG201902027.htmZHANG Y J. Effect analysis of color Doppler ultrasound combined with X-ray molybdenum target in the diagnosis of benign and malignant breast tumors[J]. J ShanXi Staff Med Coll, 2019, 29(2): 55-57. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZG201902027.htm [19] 刘隽悦, 彭东, 田艺, 等. 彩色多普勒超声联合乳腺钼靶X线诊断乳腺癌患者的临床应用及其诊断效能分析[J]. 中国数字医学, 2020, 15(4): 111-113. doi: 10.3969/j.issn.1673-7571.2020.04.035LIU J Y, PENG D, TIAN Y, et al. Clinical application of color Doppler ultrasound combined with mammography in the diagnosis of breast cancer patients and analysis of its diagnostic efficacy[J]. China Dig Med, 2020, 15(4): 111-113. doi: 10.3969/j.issn.1673-7571.2020.04.035 [20] 黄笑, 王文侠, 李平. 乳腺超声结合钼靶摄影在乳腺疾病诊断中的检出率[J]. 中国继续医学教育, 2019, 11(13): 85-87. doi: 10.3969/j.issn.1674-9308.2019.13.041HUANG X, WANG W X, LI P. Detection rate of breast ultrasound combined with molybdenum target photography in the diagnosis of breast diseases[J]. China Cont Med Educ, 2019, 11(13): 97-99. doi: 10.3969/j.issn.1674-9308.2019.13.041 [21] 杨春南. 彩超与乳腺钼靶X线诊断乳腺癌的诊断效能研究[J]. 影像研究与医学应用, 2021, 5(8): 187-188. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYY202108090.htmYANG C N. Diagnostic efficacy of color Doppler ultrasound and mammography in the diagnosis of breast cancer[J]. Imag Res & Med Appl, 2021, 5(8): 187-188. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYY202108090.htm [22] 李俏颖, 李俏颜, 赵鹏, 等. 钼靶和超声联合检查对乳腺良恶性病变的鉴别诊断价值[J]. 中国肿瘤临床与康复, 2019, 26(7): 800-803. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZK201907012.htmLI Q Y, LI Q Y, ZHAO P, et al. Value of combined mammography and ultrasound in differential diagnosis of benign and malignant breast lesions[J]. China Cance Clin & Rehab, 2019, 26(7): 800-803. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZK201907012.htm -
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