CAJ | 학술논문

目的初步探讨能谱CT成像对乳腺癌的诊断价值.方法选择乳腺钼靶图像美国放射学会(ACR)乳腺影像学报告和数据系统(BI-RADS)评分为4～5分的32例住院患者进行非增强能谱CT扫描,观察能谱图像、能谱曲线、病灶形态、大小、胸大肌是否侵犯及腋窝淋巴结有无转移等,并与乳腺钼靶图像对照.结果 32例患者均经手术病理证实为乳腺癌,其中浸润性导管癌16例,髓样癌1例,浸润性小叶癌15例.胸大肌侵犯11例,腋窝淋巴结转移9例,ACRBI-RADS评分4分者23例,5分者9例.腋窝淋巴结转移的能谱曲线与原发病灶曲线基本一致.能谱CT成像能显示病灶形态、大小,与胸大肌的关系及腋窝淋巴结转移情况,乳腺癌能谱曲线在40～ 70 keV呈明显下降趋势.在显示病灶形态、边缘、病灶内钙化、邻近皮肤增厚方面能谱CT与钼靶比较差异无统计学意义(P＞0.05),但能谱CT在显示胸大肌侵犯及腋窝淋巴结转移方面优于钼靶,差异有统计学意义(P＜0.05).结论能谱CT扫描在乳腺癌诊断中有较大临床价值,能为临床提供多参数的影像学支持.
목적 초보탐토능보CT성상대유선암적진단개치.방법 선택유선목파도상미국방사학회(ACR)유선영상학보고화수거계통(BI-RADS)평분위4～5분적32례주원환자진행비증강능보CT소묘,관찰능보도상、능보곡선、병조형태、대소、흉대기시부침범급액와림파결유무전이등,병여유선목파도상대조.결과 32례환자균경수술병리증실위유선암,기중침윤성도관암16례,수양암1례,침윤성소협암15례.흉대기침범11례,액와림파결전이9례,ACRBI-RADS평분4분자23례,5분자9례.액와림파결전이적능보곡선여원발병조곡선기본일치.능보CT성상능현시병조형태、대소,여흉대기적관계급액와림파결전이정황,유선암능보곡선재40～ 70 keV정명현하강추세.재현시병조형태、변연、병조내개화、린근피부증후방면능보CT여목파비교차이무통계학의의(P＞0.05),단능보CT재현시흉대기침범급액와림파결전이방면우우목파,차이유통계학의의(P＜0.05).결론 능보CT소묘재유선암진단중유교대림상개치,능위림상제공다삼수적영상학지지.
Objective To explore the value of energy spectrum CT in the diagnosis of breast cancer.Methods Thirty-two hospitalized patients whose American Colledge of Radiology (ACR) breast imaging reporting and data system (BI-RADS) scores were 4-5 by mammography received non-enhanced spectral CT scans.The spectrum images,spectrum curve,lesion's size,morphology were observed,and also the pectoralis major muscle and axillary lymph node metastasis were evaluated and compared with mammography.Results Thirty-two patients were confirmed by pathology,including 16 cases of invasive duct carcinomas,1 case of medullary carcinoma,15 cases of lobular carcinomas,and 11 cases of the pectoralis major muscle invaded,9 cases of the axillary lymph nodes metastasis.ACR BI-RADS scores 4 were 23 cases,5 were 9 cases.Axillary lymph node metastasis and primary tumor spectrum curves were basically the same.Energy spectrum CT showed the lesion's shape,size,the relationship with the pectoralis major muscle and axillary lymph node metastasis.In 40-70 keV spectrum curve breast cancer displayed a downward trend.There were no significant differences between energy spectrum CT and mammography for the lesion's shape,edge,internal calcification and thickening of adjacent skin (P ＞ 0.05).While energy spectrum CT exhibited obvious advantages in demonstrating the pectoralis major muscle invaded and axillary lymph node metastasis (P ＜ 0.05).Conclusion Energy spectrum CT imaging displays greater clinical value for diagnosing breast cancer,and it can provide multi-parameter image for supporting clinical practice.