摘要
目的应用受试者工作特征曲线(ROC)评价钼靶摄影术、超声与磁共振增强在乳腺肿块良恶性诊断中的价值。方法采用钼靶摄影术、超声与磁共振动态增强和三者联合检测方法对120例乳腺肿块患者的影像资料进行评价,根据乳腺病灶的大小、形态、边缘、包膜、内部回声、后方回声以及有无微钙化灶、动态增强曲线等特征,以手术病理诊断为金标准,按完全肯定良性、可能良性、不确定、可能恶性、肯定恶性5个诊断精度,分别作出4种影像方法对乳腺肿块良恶性诊断的ROC分析评价。结果 ROC评价显示联合应用的ROC曲线比其他曲线更偏左上角,曲线下面积为三者联合(0.986)>磁共振增强(0.921)>超声(0.836)>钼靶(0.821);联合运用对乳腺肿块良恶性诊断较三者单独运用准确(P<0.05),磁共振增强与钼靶、超声检查比较差异有显著性(P<0.05),钼靶与超声检查间差异无显著意义(P>0.05)。结论磁共振增强检查在乳腺癌早期诊断中价值优于超声和钼靶摄影术,三者联合运用优于单独检查。
Objective To evaluate the application value of ultrasound, mammography and MRI contrast - enhanced scans in the benign and malignant diagnosis of breast lump using receiver operating characteristic （ROC） analysis. Methods 120 patients clinically suspected breast lump were respectively examined with ultrasound, mammography, MRI contrast - enhanced scans and combination of these examinations. The diagnosis was made according to size, shape, borderline, envelope, inner and post echo, microcalcification, and dynamic enhancement curve. The surgical findings and pathology were taken as ＂gold standard＂, the results were evaluated by ROC analysis using five - point categorical scale ranged from definitely abnormal to definitely norm. Results It was shown that the ROC curve for diagnosis with combination of ultrasound, mammography and MRI contrast - enhanced scans was closer to the ideal discrimination function than those with ultrasound, mammography alone and MRI contrast - enhanced scans. The area under ROC curve for diagnosis with combination of ultrasound, mammography and MRI contrast - enhanced scans （0. 986 ） was significantly （ P 〈 0. 05 ） larger than that with MRI contrast - enhanced scans （0. 921 ） , ultrasound （0. 836） or mammography（0. 821 ）. Conclusion Combination of ultrasound, mammography and MRI contrast -enhanced scans can provide more value than ultrasound, mammography or MRI contrast -enhanced scans alone in the screening and early diagnosis of breast carcinoma.
出处
《中国医学创新》
CAS
2009年第26期149-151,共3页
Medical Innovation of China
关键词
ROC曲线
乳房钼靶摄影
超声检查
磁共振
乳腺癌
ROC curve
Mammography
Ultrasonography
Magnetic resonance image
Breast carcinoma
