The Assessment Of Diagnostic Efficacy In Breast Architectural Distortion At Mammography Vs Digital Breast Tomosynthesis

Objective: To investigate the diagnostic efficacy of mammography and digital breast tomosynthesis on breast architectural distortion.Methods: A retrospective study,81 female patients who had mammography and digital breast tomosynthesis from August 2015 to October 2019 in our hospital were selected.The main imaging features were architectural distortion(AD).With pathological results,except for injury,surgery,radiation and chemoradiation.Using ssps22.0 to analyze the data.The pathological results were regarded as "gold standard",the sensitivity,specificity and accuracy were analyzed.And chi-square test was used for comparison.It was found that the difference was statistically significant(P < 0.05).According to the calculation formula(sensitivity+specificity-1),to calculate Youden index.Results: To pathology results for the gold standard,using McNemar-Bowker test,the sensitivity of mammography and DBT to the diagnosis of breast architectural distortion was 68.2%,88.6%,P=0.049(P<0.05),and the difference was statistical.The sensitivity of mammography combined with DBT in the diagnosis of breast architectural distortion was 97.7%,which was statistically significant compared with mammography(68.2%),P = 0.01,(P<0.05),and the difference was statistical;which was statistically significant compared with DBT(88.6%),P=0.219(P>0.05),the difference was not statistically significant.The specificity of mammography and DBT to the diagnosis of breast architectural distortion was 67.6%,56.8%,P=0.388(P>0.05),the difference was not statistically significant.The specificity of mammography combined with DBT in the diagnosis of breast architectural distortion was 35.1%,which was statistically significant compared with mammography(67.6%),P <0.001,the difference was statistical;which was statistically significant compared with DBT(56.8%),P=0.039(P<0.05),the difference was statistical.The Youden index of mammography ?DBT and mammography combined with DBT was 35.8%?45.4%?32.8%.The sensitivity of mammography,DBT and mammography combined with DBT in the diagnosis of mammary gland diseases with " architectural distortion " like lesions were 79.2%,62.5%,50%,the sensitivity of mammography compared with DBT,P= 0.453(P>0.05),the difference was not statistically significant;The sensitivity of mammography compared with mammography combined with DBT,P=0.031(P<0.05),the difference was statistical;the sensitivity of DBT compared with mammography combined with DBT,P= 0.453(P>0.05),the difference was not statistically significant.The sensitivity of mammography,DBT and mammography combined with DBT in the diagnosis of invasive ductal carcinoma of the breast with " architectural distortion" like lesions 72.2%,91.7%,97.2%,the sensitivity of mammography compared with DBT,P=0.065(P>0.05),the difference was not statistically significant;The sensitivity of mammography compared with mammography combined with DBT,P=0.004(P<0.05),the difference was statistical;the sensitivity of DBT compared with mammography combined with DBT,P=0.625(P>0.05),the difference was not statistically significant.Conclusion: DBT is better than mammography in the diagnosis of "architectural distortion" of breast.The combination of mammography and DBT can improve the sensitivity of breast architectural distortion.