文章：

对比增强乳腺摄影引导下活检在广泛可疑微钙化患者中的应用

Contrast-Enhanced Mammography-Guided Biopsy in Patients with Extensive Suspicious Microcalcifications

原文发布日期：22 September 2025

DOI: 10.3390/cancers17183086

类型: Article

开放获取: 是

英文摘要：

Objectives: To investigate the feasibility of contrast-enhanced mammography-guided biopsy (CEM-Bx) to diagnose cancer via targeting the associated enhancements in the patients with extensive suspicious microcalcifications.Methods: All the women with extensive suspicious microcalcifications were mammographically screened. Contrast-enhanced mammography was first examined, followed by CEM-Bx if there was any relevant enhancement; otherwise, patients without enhancement were submitted to conventional mammography-guided biopsy (MG-Bx). We recorded and analyzed the histological results, morphologies and distributions of the microcalcifications. The outcomes were also compared to those patients (control group) who did not assess with CEM and received MG-Bx only by the Wilcoxon rank-sum test.Results: Between November 2021 and November 2023, a total of 61 participants participated in the test. A total of 26 women underwent CEM-Bx, and 35 underwent MG-Bx. In total, 19 of the 26 CEM-Bx were diagnosed as cancer, and none by MG-Bx. The cancer diagnostic rates (CDRs) identified by CEM-Bx were 81.8% for regional microcalcifications and 66.7% for segmental or diffuse distributions. The CDR of the test group was higher than the control group, 31.4% to 20%, respectively. Otherwise, the CDR of CEM-Bx was significantly higher than MG-Bx in the control group (73.08% to 20%,p-valve < 0.01).Conclusions: CEM-Bx was a safe and feasible procedure. With identification of the enhanced target, CEM-Bx faithfully performed among the extensive distributed suspicious microcalcifications. Although CEM-Bx improves CDR, larger prospective trials with surgical validation of all lesions are needed before widespread adoption.

摘要翻译： 

目的：探讨对比增强乳腺摄影引导活检（CEM-Bx）通过靶向增强区域，在广泛可疑微钙化患者中诊断癌症的可行性。 方法：对所有存在广泛可疑微钙化的女性进行乳腺X线筛查。首先进行对比增强乳腺摄影检查，若发现相关增强区域则行CEM-Bx；若无增强，则对患者行传统乳腺X线引导活检（MG-Bx）。记录并分析组织学结果、微钙化的形态与分布特征。同时通过Wilcoxon秩和检验，将结果与未接受CEM评估、仅行MG-Bx的对照组患者进行比较。 结果：2021年11月至2023年11月期间，共61名参与者纳入研究。其中26名女性接受CEM-Bx，35名接受MG-Bx。在26例CEM-Bx中，共19例诊断为癌症，而MG-Bx组未检出癌症。CEM-Bx对区域性微钙化的癌症诊断率（CDR）为81.8%，对节段性或弥漫性分布的微钙化诊断率为66.7%。试验组的总体CDR（31.4%）高于对照组（20%）。此外，试验组中CEM-Bx的CDR显著高于对照组的MG-Bx（73.08% vs 20%，p值<0.01）。 结论：CEM-Bx是一种安全可行的操作技术。通过识别增强靶区，CEM-Bx能精准应用于广泛分布的可疑微钙化病灶。尽管CEM-Bx提高了癌症诊断率，但在广泛推广前仍需通过更大规模的前瞻性试验，并对所有病灶进行手术病理验证。

原文链接：

Contrast-Enhanced Mammography-Guided Biopsy in Patients with Extensive Suspicious Microcalcifications