彩色多普勒超声、钼靶X线摄影与磁共振成像在触诊阴性乳腺癌诊断中的应用价值对比-现代医学

彩色多普勒超声、钼靶X线摄影与磁共振成像在触诊阴性乳腺癌诊断中的应用价值对比

单位：1. 海南医学院第一附属医院放射科, 海南海口 570102;
2. 海南医学院医学影像系, 海南海口 570102;
3. 海南医学院第一附属医院超声科, 海南海口 570102

分类号：R737.9;R445

出版年·卷·期（页码）：2017·36·第十二期（1813-1818）

摘要：

目的：对比彩色多普勒超声、钼靶X线摄影与磁共振成像（MRI）在触诊阴性乳腺癌诊断中的应用价值。方法：选择2011年9月至2017年12月因乳房胀痛、乳腺肿块等症状来我院就诊的触诊阴性乳腺癌患者91例，病理诊断为恶性病灶患者（恶性组）30例和良性病灶患者（良性组）61例，记录所有患者的彩色多普勒超声、钼靶X线摄影与MRI诊断特征，判定三种诊断方式的诊断价值。结果：钼靶X线在恶性组的患者中，多可见微小钙化的致密乳腺腺体，有肿块影，其边缘可见毛刺征，与良性组对比差异明显（P<0.05）。恶性组中MRI BI-RADS分级中Ⅰ型曲线1例，Ⅱ型曲线2例，Ⅲ型曲线8例，Ⅳ型曲线19例；良性组中分别为30例、27例、2例和2例两组对比差异有统计学意义（P<0.05）。钼靶X线摄影判定为恶性病灶33例，良性病灶58例；彩色多普勒超声判定为恶性病灶35例，良性病灶56例；MRI判定为恶性病灶32例，良性病灶59例。为此彩色多普勒超声、钼靶X线摄影与MRI在触诊阴性乳腺癌诊断中的敏感性与特异性分别为88.5%、93.3%、88.5、86.7%、96.7%和100.0%。结论：彩色多普勒超声、钼靶X线摄影与MRI在触诊阴性乳腺癌诊断中的应用都有比较好的价值，在临床诊断中可三者结合使用，从而提高乳腺癌的诊断效果。

Objective: To compare the diagnostic value of color Doppler ultrasonography, mammography and magnetic resonance imaging (MRI) in the diagnosis of negative breast cancer.Methods: From September 2011 to December 2017, 91 patients with nonpalpable breast cancer due to breast pain, breast lumps and other symptoms in our hospital were selected, including 30 patients with malignant tumors (malignant group) and 61 patients of benign lesions (benign group), their diagnostic features of all patients with color Doppler ultrasound, mammography and MRI were recorded.Results: Compared with the benign group, mammography in the malignant group mostly showed dense glands, tiny calcification, marginal edge burr and mass image (P<0.05). In the malignant group, 1 patient had MRI BI-RADS, 2 patients type Ⅱ curve, 8 patients type Ⅲ curve, 19 patients type Ⅳ curve. while correspondingly 30 patientshad typeⅠcurve, 27 patients type Ⅱ curve, 2 patients type Ⅲ curve and 2 patients type Ⅳ curve in the benign group, and the difference between the two groups being statistically significant (P<0.05). Mammography turned out 33 patients of malignant lesions, 58 benign lesions; color Doppler ultrasounddetermined in 35 malignant lesions, 56 benign lesions; MRIdetermined32 patients with malignant lesions, 59 benign lesions, The sensitivity and specificity of color Doppler ultrasound, mammography and MRI in the diagnosis of breast cancer were 88.5%,93.3%,88.5%,86.7%,96.7% and 100.0%.Conclusion: Color Doppler ultrasound, mammography and MRI in the diagnosis of nonpalpable breast cancer have relatively good effect, however a Combined use of the three methods can improve the effect of diagnosis of breast cancer.

参考文献：

[1] PHI X A,HOUSSAMI N,HOONING M J,et al.Accuracy of screening women at familial risk of breast cancer without a known gene mutation:Individual patient data meta-analysis[J].Eur J Cancer,2017,5(85):31-38.
[2] 张讴.乳腺癌超声诊断漏诊及误诊分析[J].航空航天医学杂志,2017,28(2):189-190.
[3] WOODARD G A,RAY K M,JOE B N,et al.Qualitative radiogenomics:association between oncotype dx test recurrence score and bi-rads mammographic and breast mr imaging features[J].Radiology,2017,8(16):2333.
[4] 杨培,陈颖,史春颖.数字化乳腺X线摄影和超声成像对临床触诊阴性乳腺癌诊断价值的对比研究[J].哈尔滨医科大学学报,2017,51(1):41-43.
[5] KOLOR K,CHEN Z,GROSSE S D,et al.BRCA genetic testing and receipt of preventive interventions among women aged 18-64 years with employer-sponsored health insurance in nonmetropolitan and metropolitan areas-united states,2009-2014[J].MMWR Surveill Summ,2017,66(15):1-11.
[6] CHO I H,KONG E J.Potential Clinical applications of (18)F-fluorodeoxyglucose positron emission tomography/Magnetic resonance mammography in breast cancer[J].Nucl Med Mol Imaging,2017,51(3):217-226.
[7] 马继斌,曾理.超声联合CT诊断乳腺肿块性质的临床价值分析[J].中国CT和MRI杂志,2017,15(5):71-73.
[8] CHIRIŢ Ǎ A.Indications of the magnetic resonance method in breast pathology[J].Chirurgia (Bucur),2017,112(4):367-377.
[9] CORTADELLAS T,ARGACHA P,ACOSTA J,et al.Estimation of tumor size in breast cancer comparing clinical examination,mammography,ultrasound and MRI-correlation with the pathological analysis of the surgical specimen[J].Gland Surg,2017,6(4):330-335.
[10] 董江宁,韦超,方昕,等3.0 T MRI结合全数字化乳腺X线诊断触诊阴性乳腺癌的价值[J].安徽医科大学学报,2017,52(1):135-138.
[11] YAMAMOTO S,CHISHIMA T.Can magnetic resonance imaging obviate the need for biopsy for microcalcifications?[J].Gland Surg,2017,6(4):302-307.
[12] ALANIS L,ROTH R,LERMAN N,et al.Radiologic images of an aggressive implant-associated fibromatosis of the breast and chest wall:case report and review of the literature[J].Radiol Case Rep,2017,12(3):431-438.
[13] HA S M,CHAE E Y,CHA J H,et al.Association of BRCA mutation types,imaging features,and pathologic findings in patients with breast cancer with brca1 and brca2 mutations[J].AJR Am J Roentgenol,2017,8(10):1-9.
[14] STRIGEL R M,BURNSIDE ES,ELEZABY M,et al.Utility of BI-RADS assessment category 4 subdivisions for screening breast MRI[J].AJR Am J Roentgenol,2017,208(6):1392-1399.
[15] 王方,杨向丽,邢祉,等.乳腺影像报告与数据系统评估联合乳腺微钙化导丝定位活组织检查对触诊阴性乳腺癌的诊断价值[J].肿瘤研究与临床,2017,29(4):241-244.
[16] PATEL B K,GARZA S A,EVERSMAN S,et al.Assessing tumor extent on contrast-enhanced spectral mammography versus full-field digital mammography and ultrasound[J].Clin Imaging,2017,46(54):78-84.
[17] TELJEUR C,MORAN P,HARRINGTON P,et al.The HIQA's health technology assessment of breast screening:highlighting some of the challenges posed by evaluations of screening programs[J].Value Health,2017,20(7):1000-1002.
[18] 田宏哲,武宝华,何海林,等.超声联合MRI多定量参数检测在触诊阴性乳腺癌诊断中的应用[J].中国医师杂志,2017,19(1):138-140.
[19] LIAO C Y,WU Y T,WU W P,et al.Role of breast magnetic resonance imaging in predicting malignant invasion of the nipple-areolar complex:Potential predictors and reliability between inter-observers[J].Medicine (Baltimore),2017,96(28):e7170.
[20] 张丽,韩立新,曹惠霞,等.3.0T磁共振扩散加权成像和VIBRANT动态增强在鉴别乳腺腺病与乳腺癌中的价值[J].临床放射学杂志,2017,36(3):342-346.
[21] LEE S,JEONG H,SEONG M,et al.Change of tumor vascular reactivity during tumor growth and postchemotherapy observed by near-infrared spectroscopy[J].J Biomed Opt,2017,22(12):121603.
[22] 张建军.声触诊组织成像量化和剪切波弹性成像在乳腺肿瘤诊断中的应用价值[J].中国药物与临床,2016,16(7):987-989.
[23] KO K H,JUNG H K,KIM I.Analysis of background parenchymal echogenicity on breast ultrasound:Correlation with mammographic breast density and background parenchymal enhancement on magnetic resonance imaging[J].Medicine (Baltimore),2017,96(33):e7850.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录