钼靶X线与动态增强磁共振扫描对乳腺疾病诊断的对比研究  

Comparative study of mammography and dynamic contrast-enhanced magnetic resonance imaging on diagnosis of breast disease

作　　者：朱西琪[1] 丁怀银[1] 谢正平[1] 袁莉莉[1] 

机构地区：[1]东南大学附属第二医院放射科,江苏南京210003

出　　处：《重庆医学》2011年第18期1802-1803,1806,共3页Chongqing medicine

摘　　要：目的比较钼靶X线摄影与动态增强磁共振扫描(DCE-MRI)诊断乳腺疾病的敏感性和特异性。方法 50例患者共63枚病灶,其中恶性29例34枚病灶,良性21例29枚病灶。钼靶X线摄影采用参数自动优化(AOP)曝光模式;DCE-MRI采用乳腺表面相控阵线圈,常规扫描短时间反转恢复序列(STIR)、T1加权像(T1WI)、T2加权快速自旋回波序列(FSE-T2)抑脂序列以及Vibrant动态增强序列。比较两种检查方法诊断乳腺病变的敏感性、特异性、准确率、阳性预测值、阴性预测值以及两种检查方法诊断的符合度。结果钼靶X线摄影与DCE-MRI检查显示拟诊恶性病灶数均为32枚,但与病理对照的灵敏度、特异度、阳性预测值和阴性预测值分别为67.65%(23/34)6、8.97%(20/29)、71.88%(23/32)、64.52%(20/31)和85.29%(29/34)、89.66%(26/29)、90.63%(29/32)、83.87%(26/31);良性病灶时间-信号强度曲线多为Ⅲ型,恶性病灶时间-信号强度曲线多为Ⅰ型或Ⅱ型。结论 DCE-MRI诊断乳腺疾病的敏感性及特异性均高于钼靶X线摄影。Objective To compare sensitivity and specificity of mammography and dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI） in breast disease diagnosis.Methods 50 patients had a total of 63 lesions,including 34 malignant lesions in 29 patients and 29 benign lesions in 21 patients.Mammography using automatic optimization parameter（AOP） exposure mode and DCE-MRI with the breast surface phased array coil,conventional scanning STIR,T1WI,FSE-T2 fat suppression sequences and Vibrant dynamic enhanced sequence were employed to detect breast leions.Sensitivity,specificity,accuracy rate,positive and negative predictive value and conformity of the two methods in breast lesion diagnosis were analyzed comparatively.Results Both mammography and DCE-MRI revealed the number of positive lesions were 32,but the sensitivity,specificity and accuracy rate,positive and negative predictive value of them were 67.65%（23/34）,68.97%（20/29）,71.88%（23/32）,64.52%（20/31） and 85.29%（29/34）,89.66%（26/29）,90.63%（29/32）,83.87%（26/31）,respectively,according to the results of pathology.Time-signal intensity curve of benign lesion were mostly type Ⅲ while that of malignant lesions were mostly type Ⅰ or type Ⅱ.Conclusion Sensitivity and specificity of DCE-MRI are higher than those of mammography in breast disease diagnosis.

关 键 词：乳腺肿瘤 磁共振成像 乳房X线摄影术 诊断技术和方法 

分 类 号：R655.8[医药卫生—外科学] R445.2[医药卫生—临床医学]