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目的探讨结合伪彩成像提高胸部CT平扫乳腺癌检出率的价值。方法搜集经病理证实的乳腺癌患者30例(共60只乳腺),由两名医师分别独立阅读胸部CT平扫纵隔窗图像判断是否存在乳腺癌病灶,2周后应用胸部平扫CT图像结合伪彩成像技术阅片判断是否存在乳腺癌病灶。采用Kappa方法计算两名医师的一致性,采用卡方检验验证结合伪彩成像技术可否提高胸部CT平扫乳腺癌检出率。结果纤维腺体松散分布的乳腺(Ⅰ类,13例)中,乳腺癌灶的CT值平均值高于正常腺体的CT值平均值[(21.0±13.0)HU vs(-28.1±32.8)HU](P<0.001),纤维腺体致密分布的乳腺(Ⅱ类,17例)中亦如此[(34.3±12.5)HU vs(1.9±21.7)HU](P<0.001)。在Ⅱ类乳腺中,两名医师在CT平扫图像下阅片的评价结果具有高度一致性(Kappa=0.852,P<0.001),采用CT平扫结合伪彩成像阅片方式的评价结果具有较高一致性(Kappa=0.798,P<0.001)。单纯CT平扫阅片方式及平扫结合伪彩成像阅片方式在Ⅰ类乳腺中检测乳腺癌的敏感性均为100%(13/13),平扫结合伪彩在Ⅱ类的乳腺中检测肿瘤的敏感性高于平扫阅片(94.1%vs.64.7%,P<0.05)。结论 CT平扫结合伪彩成像技术较之传统CT阅片可以提高纤维腺体致密分布的乳腺内癌灶的检出率。
Objective To explore the value of using pseudo-color imaging to improve the detection rate of chest CT in breast cancer. Methods Thirty patients with pathologically confirmed breast cancer (60 mammograms) were collected. Two physicians independently read chest CT images of the mediastinum window to determine the presence or absence of breast cancer. Two weeks later, CT images of the thorax were combined with the false Color imaging technology readings to determine the existence of breast lesions. Kappa method was used to calculate the consistency between the two doctors. The chi-square test was used to verify whether the combination of pseudo-color imaging can improve the detection rate of chest CT scan. Results The average value of CT value of breast cancer was higher than that of normal gland [(21.0 ± 13.0) HU vs (-28.1 ± 32.8) HU (P <0.001). The same was true for fibroadenosomally distributed breasts (category II, 17 cases) (34.3 ± 12.5 vs. HU vs 1.9 ± 21.7 HU, P <0.001). In type II, the two doctors had a high degree of agreement (Kappa = 0.852, P <0.001) for the interpretation of the radiographs under the CT scan images. The evaluation results of CT plain scan combined with pseudo-color imaging readings High agreement (Kappa = 0.798, P <0.001). Simple CT scan and plain scan combined with pseudo-color imaging reading methods in the detection of breast cancer Ⅰ type of sensitivity was 100% (13/13), plain scan with false color in the detection of breast Ⅱ The sensitivity of tumor was higher than that of plain scan (94.1% vs.64.7%, P <0.05). Conclusion CT scan combined with pseudo-color imaging technology compared with traditional CT reading can improve the dense distribution of fibrous glands within the detection rate of intraductal foci.