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目的探讨乳腺触觉成像(palpationimaging,PI)对乳腺疾病的诊断价值。方法对2010年10月至2011年3月在上海交通大学医学院附属瑞金医院乳腺外科就诊的151例病人共计213个病灶,行PI、B超、钼靶及磁共振成像(MRI)检查,各检查方法独立进行。以病理诊断为金标准,通过受试者工作特征曲线(ROC曲线)评估PI对乳房病灶的诊断价值,并比较不同方法诊断结果的差异。结果 PI对病灶的良恶性具有较好的诊断价值(AUC=0.832,95%CI:0.766～0.898,P<0.001),敏感度为87.0%,显著高于钼靶(63.5%,P=0.005),与B超(87.0%)及MRI(94.0%)相比差异无统计学意义。PI的特异度及准确率为69.8%与74.2%,与钼靶相比差异无统计学意义(80.5%,P=0.041,未达到调整后检验水准α’=0.0083;75.4%,P=0.778),但显著低于B超(86.2%,P<0.001;86.4%,P=0.002)及MR(I85.7%,P=0.005;88.7%,P<0.001)。结论 PI对于乳房疾病具有良好的诊断价值,有望成为乳腺疾病现有辅助检查外的又一种重要检查方法。
Objective To investigate the value of breast palpationimaging (PI) in the diagnosis of breast diseases. Methods Totally 213 lesions of 151 patients treated in Department of Breast Surgery, Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine from October 2010 to March 2011 were examined with PI, B ultrasound, mammography and magnetic resonance imaging (MRI) The inspection method is carried out independently. According to the pathological diagnosis as the gold standard, the diagnostic value of PI for breast lesions was evaluated by receiver operating characteristic curve (ROC curve), and the differences between different methods were compared. Results PI had a good diagnostic value for the benign and malignant lesions (AUC = 0.832, 95% CI: 0.766-0.898, P <0.001), the sensitivity was 87.0%, which was significantly higher than that of molybdenum target (63.5%, P = 0.005) , There was no significant difference compared with B ultrasound (87.0%) and MRI (94.0%). The specificity and accuracy of PI were 69.8% and 74.2%, respectively. There was no significant difference between the two groups (80.5%, P = 0.041, α = 0.0083; 75.4%, P = 0.778) , But significantly lower than that of B ultrasound (86.2%, P <0.001; 86.4%, P = 0.002) and MR (I85.7%, P = 0.005; 88.7%, P <0.001). Conclusion PI has a good diagnostic value for breast disease and is expected to become another important examination method besides the existing auxiliary examination of breast disease.