| Objective: To discuss digital breast tomosynthesis(DBT)in the diagnosis of breast fibroadenoma(FA).Materials and Methods: A retrospectively analyse was performed on total 868 lesions in673 patients who were confirmed by operation and pathology as breast fibrodenoma.The FA whose Digital Mammography(DM)and Ultrasonography(US)images showed the following typical imaging : round or oval,clear boundary,equal or slightly high density shadow,and typical calcification of large popcorn pattern,and low echo,aspect ratio?1were classified as typical;and whose Digital Mammography(DM)and Ultrasonography(US)images showed the following atypical imaging : irregular shape,obscure boundary,angular or burr-shaped edge,high density,aspect ratio >1,rear echo attenuation,suspicious malignant calcification,focal asymmetry density,structure distortion and false negative under single examination method were classified as atypical.Among them,180 were typical group,688 were atypical group.Then,the mass lesions were assessed with reference to the 5th edition of breast imaging report and data system(BI-RADS)to perform the BI-RADS classification and breast density classification.Next,the differences in the detection rate and diagnostic accuracy of DBT,DM and US on breast fibroadenoma,different dense breasts,different pathological grade,P <0.05 was considered statistically significant.Results: 1.Breast fibroadenoma has typical and atypical imaging findings in digital breast tomosynthesis(DBT).Atypical imaging findings of mass lesions showed irregular(11.3%),unclear or blurred boundaries(37.2%),high density(4.4%),and suspected malignant calcification(1.4%);Atypical imaging findings of non-mass lesions showed architectural distortion 2,focal asymmetry 1,coarse heterogeneous 1.2.Breast fibroadenoma has typical and atypical ultrasonic appearance.Atypical ultrasound imaging of mass lesions showed irregular(23.5%),unclear boundary(21.5%),aspect ratio >1(0.5%),rear echo attenuation(6.8%),and rich blood flow(13.1%).US is less sensitive to calcification.3.DBT had a higher detection rate(75.8% vs 55.4%)and diagnostic accuracy(68.9% vs 39.2%)of breast fibroadenoma compared with DM,and had a lowerdetection rate(75.8% vs 99.5%)and diagnostic accuracy(68.9% vs93.0%)compared with US in all cases,the difference was statistically significance.US improved the detection rate(99.5% vs 55.4%)and diagnostic accuracy(93.0% vs 39.2%)of breast fibroadenoma compared with DM,the difference was statistically significance.4.There were dense breast 789(90.9%)in all cases,DBT had a higher detection rate(75.0% vs 53.0%)and diagnostic accuracy(68.4% vs 37.6%)of breast fibroadenoma compared with DM,and had a lower detection rate(75.0% vs 99.5%)and diagnostic accuracy(68.4% vs 92.8%)compared with US,the difference was statistically significance;US improved the detection rate(99.5% vs 53.0%)and diagnostic accuracy(92.8% vs 37.6%)compared with DM,the difference was statistically significance.Non-dense breast 79(9.1%),DBT had a higher diagnostic accuracy(72.2% vs 49.4%)of breast fibroadenoma compared with DM,and had a lower detection rate(83.5% vs 100%)and diagnostic accuracy(72.2%vs 94.9%)compared with US,the difference was statistically significance;DBT had a higher detection rate(83.5% vs 78.5%)compared with DM,the difference was not statistically significance;US improved the detection rate(100% vs 78.5%)and diagnostic accuracy(94.9% vs 49.4%)compared with DM,the difference was statistically significance.Conclusion:DBT greatly improved the detection rate and diagnostic accuracy of fibroadenoma,especially fibroadenoma of atypical iamging findings compared with DM,but weaker than US.X-ray is sensitive to calcification and has obvious advantages in the detection of calcific lesions and fibroadenoma of atypical iamging findings with calcified lesions.The imaging findings of fibroadenoma were not significantly correlated with pathological types.DBT has broad application prospects as a new digital mammography technology. |
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