仅通过图解合成检测到的建筑扭曲:对1361个病变的元分析
Romuald Ferre1, Cherie M Kuzmiak1
1Faculty, Division of Breast Imaging, Department of Radiology, CB #7510, UNC School of Medicine, Physicians' Office Building, Rm #118, 170 Manning Drive, Chapel Hill, NC 27599 (R.F., C.M.K.).
Academic radiology
|September 11, 2025
概括
大约有37%的仅通过数字乳腺图莫合成检测到的建筑扭曲病变是恶性的. 这一发现支持对这些病变的活检,而不是保守的管理.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 在数字乳腺图解合成 (DBT) 上的架构扭曲 (AD) 提出了诊断挑战.
- 只有在DBT上可见的病变需要准确的表征来指导管理.
研究的目的:
- 确定仅通过DBT检测到的AD病变中恶性,高风险和良性发现的比例.
- 评估现有文献中的研究间异质性和出版偏见.
主要方法:
- 2010年至2025年间发表的14个单臂队列 (1361个病变) 的系统综述和元分析.
- 使用随机效应模型计算的聚合比例;用I2和t2.2评估异质性.
- 使用漏斗图和埃格尔回归评估的出版偏差;进行了灵敏度分析.
主要成果:
- 仅DBT的AD病变的恶性病变率为37% (95%CI26-48),良性结局为41% (95%CI28-54).
- 非良性病理 (恶性+高风险) 占病变的59% (95% CI 46-73).
- 观察到极端异质性 (I2>90%),受活检方法和临床环境的影响.
结论:
- 大约三分之一的仅通过DBT检测到的AD病变是恶性的.
- 建议对这些病变进行活检,而不是短时间的随访.
- 这些发现强调了在DBT上对不确定的AD病变进行活检的重要性.
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