【摘要】 目的:研究结构扭曲型病变(architectural distortion, AD)的乳腺断层摄影(digital breast tomosynthesis, DBT)及超声检测效能，以提高恶性结构扭曲型病变的检出及诊断能力。方法:回顾性分析我院(2018.08.01-2021.04.15)全数字乳腺X线摄影(FFDM)+DBT发现的268例女性患者288处结构扭曲病灶影像学资料，以病理结果为金标准，分析DBT、超声对结构扭曲的检出效能。结果:全组包括恶性病变105处，良性病变96处，高风险病变87处。DBT较FFDM额外检出102处。全组病灶有超声相关征象组(190处)与无超声相关征象组(98处)的病变良恶性分布有统计学差异(χ~2=43.663,P=0.000)),有超声相关征象组内恶性病变占比高于无超声相关征象组[48.95%(93/190)vs 12.24%(12/98),χ~2=37.594,P=0.000]。仅DBT检出的102处AD病变中，有超声相关征象组内恶性病灶占比高于无超声相关征象组内恶性病变占比[35.42%(17/48) vs 14.81%(8/54),χ~2=5.829,P=0.016]。结论:应用DBT能提高乳腺内结构扭曲型病变的检出，联合超声对病变进行检测评估，有助于更好的预测病变的良恶性。AD病变所在乳腺相应区域合并超声可疑征象时，其恶性可能性较大；若超声无可疑征象，不可无视其恶性风险。更多还原

【Abstract】 Objective:To evaluate the diagnostic efficacy of digital breast tomosynthesis(DBT) in the detection of architectural distortion(AD)and ultrasonography correlation, and improve the detection rate and diagnostic accuracy of malinant AD.Methods:A retrospective analysis was on 268 female patients with 288 AD detected by DBT and FFDM(full-field digital mammography) between August 1,2018 and April 15,2021.Based on pathology, our aim was to analysis the ability of ultrasound and DBT to detect AD.Results:Our sample included 105 malignant lesions, 96 benign lesions and 87 high-risk lesions.There were 102 AD lesions detected only by DBT.For ultrasound-related group(n=190) and uncorrelated group(n=98),there was statistically different of pathological composition(χ~2=43.663,P=0.000).Malignancy proportion of AD with ultrasound correlate(48.95%,93/190) was significantly different from that without ultrasound correlate(12.24%,12/98)(χ~2=37.594,P=0.000).In 102 AD lesions detected by DBT alone, there were 48 cases with ultrasound-related signs and 54 cases without ultrasound-related signs.The malignancy proportion was significant difference between the above two groups [35.42%(17/48) vs 14.81%(8/54),χ~2=5.829,P=0.016].Conclusion:Architectural distortion is more commonly detected on DBT.If AD was diagnosed by ultrasoundas BI-RADS 4 A or above, it was more likely to be malignancy.However, the malignant possibility of AD only by DBT is not be ignored even in the absence of sonographic abnormalities.更多还原