致密类乳腺病变不同影像学检查方案的效果评价

doi:10.7517/issn.1674-0475.231007

影像科学与光化学 ›› 2024, Vol. 42 ›› Issue (1): 53-57.DOI: 10.7517/issn.1674-0475.231007

致密类乳腺病变不同影像学检查方案的效果评价

马财¹, 王永胜², 陈文静²

1. 上海市金山区亭林医院超声科, 上海 201505;
2. 上海市金山区亭林医院放射科, 上海 201505

收稿日期:2023-10-11 修回日期:2023-12-18 发布日期:2024-02-21
通讯作者: 陈文静
基金资助:
上海市金山区医药卫生科技创新资金项目(2022-WS-15)

Comprehensive Evaluation of the Effectiveness and Cost of Different Imaging Protocols in Breast Cancer Screening

MA Cai¹, WANG Yongsheng², CHEN Wenjing²

1. Department of Ultrasound, Tinglin Hospital, Jinshan District, Shanghai, Shanghai 201505, P.R. China;
2. Department of Radiology, Tinglin Hospital, Jinshan District, Shanghai, Shanghai 201505, P.R. China

Received:2023-10-11 Revised:2023-12-18 Published:2024-02-21

摘要/Abstract

摘要： 结合卫生经济评价致密类乳腺超声、钼靶、磁共振不同影像学检查单一或联合方案的诊断效能。回顾性分析行手术或穿刺活检的致密类乳腺130例134个病灶患者资料,所有患者均在术前2周内完成超声、钼靶及磁共振检查。结果显示单一检查方案钼靶对致密类乳腺病变诊断价值有限,磁共振诊断敏感度及特异度高,但成本-效果比高(4.84),不适合做普查,超声敏感度高,成本-效果比最低(0.99),可作为首选检查,但特异度不足,需要补充检查提高诊断效果。联合方案超声+磁共振准确度最高,增量成本-效果比最低,从卫生经济学角度在联合方案中为最优化方案。致密类乳腺超声发现可疑病变,再联合应用磁共振检查,能显著提高诊断效能。

关键词: 致密类乳腺, 超声, 钼靶, 磁共振, 卫生经济, 效果评价

Abstract: The single or combined diagnostic efficacy of ultrasound, mammography and magnetic resonance imaging in dense breast was evaluated in combination with medical economics. Data from 130 patients with 134 lesions of dense breast who underwent surgery or needle biopsy were retrospectively analyzed, and all patients completed ultrasound, mammography and magnetic resonance examination within 2 weeks before surgery. The results showed that mammography in a single examination protocol was of limited value in the diagnosis of dense breast lesions. Magnetic resonance imaging had high sensitivity and specificity, but the cost-effectiveness ratio was high (4.84), making it unsuitable for general screening. Ultrasound had high sensitivity and the lowest cost-effectiveness ratio (0.99), which could be used as the preferred examination, but had insufficient specificity, so supplementary examination was needed to improve the diagnostic effect. The combination of ultrasound and magnetic resonance had the highest accuracy and the lowest incremental cost-effectiveness ratio, making it the optimal solution from a medical economics perspective. Dense breast ultrasound has found suspicious lesions, and then combined with magnetic resonance examination, can significantly improve the diagnostic efficiency.

Key words: dense breast, ultrasound, mammography, magnetic resonance imaging, medical economics, effect evaluation

马财, 王永胜, 陈文静. 致密类乳腺病变不同影像学检查方案的效果评价[J]. 影像科学与光化学, 2024, 42(1): 53-57.

MA Cai, WANG Yongsheng, CHEN Wenjing. Comprehensive Evaluation of the Effectiveness and Cost of Different Imaging Protocols in Breast Cancer Screening[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2024, 42(1): 53-57.

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致密类乳腺病变不同影像学检查方案的效果评价

Comprehensive Evaluation of the Effectiveness and Cost of Different Imaging Protocols in Breast Cancer Screening

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