CAJ | 학술논문

目的用受试者操作特性(ROC)曲线评价数字乳腺摄影与彩色多普勒超声及二者联合应用对乳腺癌的诊断价值.方法采用完全随机法选取经手术病理证实的50例女性乳腺癌和50例乳腺良性病变,患者术前均同时经数字乳腺摄影和彩色多普勒超声检查.患者全部数字乳腺像(100份)为第1组;彩色多普勒超声图像(100份)为第2组;每例患者的数字乳腺与其超声的组合图像(共100份),为第3组.3名诊断医师分别对3组图像进行诊断,用5分法:肯定是、可能是、不确定、可能不是、肯定不是,独立诊断是否为乳腺癌.将3名医师阅片结果的平均值用SPSS 11.0版ROC曲线软件进行统计分析,3种诊断方法的ROC曲线下面积(Az)行Z检验.结果 3名医师用数字乳腺像、彩色多普勒超声图像及组合图像诊断乳腺癌的平均例数分别为42、38、48例;诊断乳腺良性病变的平均例数分别为40、43、47例.数字乳腺像诊断乳腺癌的敏感度为84%(42/50),特异度为80%(40/50);彩色多普勒超声图像诊断乳腺癌的敏感度为76%(38/50),特异度为86%(43/50);组合图像诊断乳腺癌的敏感度为96%(48/50),特异度为94%(47/50).3种方法ROC曲线下平均面积(Az值)分别为0.852、0.825、0.952.2种方法联合应用诊断乳腺癌的ROC曲线Az值较单独使用数字乳腺摄影或单独使用彩色多普勒超声诊断乳腺癌的ROC曲线Az值显著增大(Z1=2.183,Z2=2.581,P值均＜0.01).结论数字乳腺摄影与彩色多普勒超声联合应用对乳腺癌诊断的敏感度和特异度均最高,诊断价值最大,有助于乳腺癌的早期发现与诊断.
목적 용수시자조작특성(ROC)곡선평개수자유선섭영여채색다보륵초성급이자연합응용대유선암적진단개치.방법 채용완전수궤법선취경수술병리증실적50례녀성유선암화50례유선량성병변,환자술전균동시경수자유선섭영화채색다보륵초성검사.환자전부수자유선상(100빈)위제1조;채색다보륵초성도상(100빈)위제2조;매례환자적수자유선여기초성적조합도상(공100빈),위제3조.3명진단의사분별대3조도상진행진단,용5분법:긍정시、가능시、불학정、가능불시、긍정불시,독립진단시부위유선암.장3명의사열편결과적평균치용SPSS 11.0판ROC곡선연건진행통계분석,3충진단방법적ROC곡선하면적(Az)행Z검험.결과 3명의사용수자유선상、채색다보륵초성도상급조합도상진단유선암적평균례수분별위42、38、48례;진단유선량성병변적평균례수분별위40、43、47례.수자유선상진단유선암적민감도위84%(42/50),특이도위80%(40/50);채색다보륵초성도상진단유선암적민감도위76%(38/50),특이도위86%(43/50);조합도상진단유선암적민감도위96%(48/50),특이도위94%(47/50).3충방법ROC곡선하평균면적(Az치)분별위0.852、0.825、0.952.2충방법연합응용진단유선암적ROC곡선Az치교단독사용수자유선섭영혹단독사용채색다보륵초성진단유선암적ROC곡선Az치현저증대(Z1=2.183,Z2=2.581,P치균＜0.01).결론 수자유선섭영여채색다보륵초성연합응용대유선암진단적민감도화특이도균최고,진단개치최대,유조우유선암적조기발현여진단.
Objective To investigate the value of combined digital mammography and Color Doppler Mammasonography in the diagnosis of the breast carcinoma with ROC analysis.Methods Fifty female patients with breast carcinoma and fifty female patients with breast benign lesions confirmed by means of surgery and histopathological examinations were studied.All patients were examined by Digital Mammagraphy and Color Doppler Mammasonography.Images of all patients were sorted and divided into three groups,Digital radiographs of all patients was the first group,and the second group was Color Doppler photographs,and the third was included the above two photographs.Each group was evaluated respectively by three radiologists independently.The diagnostic result of breast carcinoma or benign lesions were investigated with a five point confidence-rating scale:(1)definitely positive;(2)probably positive;(3)indeterminate;(4)probably negative,and(5)definitely negative.ROC analysis was made with SPSS 11.0 software.The differences of the area under the curve for each group was made by Z test.Results The average number of breast carcinoma diagnosed by three radiologists with digital mammography,Color Doppler Mammasonogaraphy and both of them was 42,38,and 48,respectively;and the average number of breast benign lesions was 40,43,and 47,respectively.The sensitivity and specificity for digital mammography was 84%(42/50),80%(40/50),and they were 76%(38/50),86%(43/50)for Color Doppler;and 96%(48/50),94%(47/50)for two modes combination.ROC analysis indicated that the average area under the curve was 0.852 for Digital Mammagraphy,0.825 for Color Doppler,and 0.952 for both combined.For digital mammography combined with Color Doppler Mammasono-garaphy on diagnosis breast carcinoma,the area under the curve(Az)was significally larger than that for digital mammography(Z1=2.183,P＜0.01),and also larger than that for Color Doppler Mammasono-garaphy(Z2=2.581,P＜0.01), respectively.Conclusions Among three medical imaging modes on diagnosing breast carcinoma,the diagnostic value of digital mammography combined with Color Doppler Mammasono-garaphy was the highest. It was helpful on detecting and diagnosing breast carcinoma early.