乳腺癌保乳术前的动态增强MRI和X线摄影联合评估  

Evaluation of Breast Cancer before Breast- conserving Surgery by Dynamic-enhanced MRI and Mammography

作　　者：林光武[1] 刘伟 嵇鸣[1] 李尉萍[2] 叶春涛[1] 朱振方[1] 臧雪如[1] 

机构地区：[1]复旦大学附属华东医院MR室上海市静安区延安西路221号,上海200040 [2]复旦大学附属华东医院普外科

出　　处：《中国医学计算机成像杂志》2012年第1期13-17,共5页Chinese Computed Medical Imaging

基　　金：上海市卫生局科研基金(编号:H659)~~

摘　　要：目的:探讨动态增强MRI和钼靶X线摄影在乳腺癌行保乳术(BCS)的术前评估价值。方法:分析106例经手术和病理证实的乳腺癌患者的术前动态增强MRI及钼靶X线摄影资料,观测动态增强MRI和钼靶X线摄影片上乳腺癌病灶的数目、位置、大小、形态、侵犯范围和淋巴结转移情况,按乳腺癌保乳术所需条件与术后大体解剖标本及镜下病理相对照,分析单独和联合运用动态增强MRI与钼靶X线摄影对乳腺癌保乳术前的评估准确性。结果:动态增强MRI判断40例(37.8%)可行BCS,判定准确性为96.2%;钼靶X线摄影判断37例(34.9%)可行BCS,判定准确性为89.6%;动态增强MRI与钼靶X线摄影联合运用,判断41例(38.7%)可行BCS,判定准确性为97.2%。结论:联合运用动态增强MRI和钼靶X线摄影能为乳腺癌患者筛选是否适合BCS提供较全面和准确的信息。Purpose： To investigate the feasibility and value of MRI and mammography in assessing breast conserving surgery （BCS） of breast cancer. Methods： MR scanning and mammography were per- formed on 106 patients with breast cancer before operation. The location, size, extent, number of breast cancer, as well as the status of the skin of mammary gland, chest wall and axillary nodes were analyzed for all the patients on the MRI and mammography images. The macroscopic and microscopic features of these resected specimens were observed. The results of MRI, mammography and histopathology were comparatively analyzed to determine if they were eligible for BCS. Results： Forty patients （37.8%） were considered eligible for BCS by MRI alone and the diagnoisis accuracy of MRI was 96.2%. Thirty - seven patients（34.9% ） were considered eligible for BCS by mammography alone and the accuracy was 89.6%. And when MRI was combined with mammography, 41 patients （38.7%） were considered eligible for BCS and the accuracy was 97.2%. Conclusion： Combined dynamic- enhanced MRI with mammography can provide complete and accurate information on breast cancer for BCS.

关 键 词：乳腺癌 保乳术 磁共振成像 钼靶X线摄影 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.56[医药卫生—诊断学]