钼靶X线及超声在乳腺导管原位癌诊断中的价值  

Value of mammography and ultrasonography in diagnosis of breast ductal carcinoma in situ

作　　者：谢菲[1] 周波[1] 杨德起[1] 刘鹏[1] 

机构地区：[1]北京大学人民医院乳腺疾病中心,北京100044

出　　处：《中国医学影像技术》2012年第7期1314-1317,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨乳腺导管原位癌(DCIS)的钼靶X线和超声特点及诊断价值。方法回顾性分析95例乳腺DCIS患者的钼靶X线和超声特点,比较二者诊断DCIS的敏感度和对肿物及钙化的检出率。结果 16例钼靶X线片可见肿物,其中圆形8例(8/16,50.00%),分叶形6例(6/16,37.50%),不规则形2例(2/16,12.50%)。边缘浸润10例(10/16,62.50%),边缘清楚6例(6/16,37.50%)。77例钼靶X线片中可见钙化,42例钙化呈细线状或细分支状(42/77,54.55%),35例表现为多形性(35/77,45.45%);钙化呈簇状分布44例(44/77,57.14%),区段分布25例(25/77,32.47%),线样分布8例(8/77,10.39%)。70例超声可见肿物,圆形38例(38/70,54.29%),分叶状29例(29/70,41.43%),不规则形3例(3/70,4.29%);肿物边缘不清楚53例(53/70,75.71%),边缘清楚17例(17/70,24.29%)。根据检出肿物和钙化,钼靶X线和超声诊断DCIS的敏感度分别为77.89%(74/95)和42.11%(40/95,P<0.001),二者联合诊断准确率可提高至89.47%(85/95,P<0.05)。钼靶和超声对肿物的检出率分别为16.84%(16/95)和73.68%(70/95,P<0.001),对钙化的检出率分别为81.05%(77/95)和12.63%(12/95,P<0.001)。结论钼靶X线对钙化的诊断较敏感,而超声对肿物的检出率更高,二者联合可明显提高诊断DCIS的敏感度。Objective To investigate the mammographic and ultrasonographic（US） features and diagnostic value on breast ductal carcinoma in situ（DCIS）.MethodsA retrospective analysis of the mammographic and US findings of 95 patients with breast DCIS was performed,and the sensitivity and detection rate of the two method were compared.ResultsSixteen patients showed masses in mammography,of which 8 masses（8/16,50.00%） were round,6（6/16,37.50%） were lobulated,and 2（2/16,12.50%） were irregular shape.Ten（10/16,62.50%） of them had indistinct margins,6（6/16,37.50%） had distinct margins.Seventy-seven lesions were demonstrated microcalcification in mammography,and 42（42/77,54.55%） were fine-linear or branching,35（35/77,45.45%） fine-pleomorphic.Forty-four（44/77,57.14%） lesions presented clustered distribution,25（25/77,32.47%） segmental distribution and 8（8/77,10.39%） linear distribution.Seventy patients showed masses in US,38（38/70,54.29%） were round,29（29/70,41.43%） lobulated,and 3（3/70,4.29%） irregular.Fifty-three（53/70,75.71%） patients had poor defined margins,17（17/70,24.29%） had clear defined margins.The sensitivity of mammography and US in detecting DCIS was 77.89%（74/95） and 42.11%（40/95,P〈0.001）,respectively.The sensitivity was improved to 89.47%（85/95） when combining mammography and US（P〈0.05）.The detection rate of mass with mammography and US was 16.84%（16/95） and 73.68%（70/95,P〈0.001）,respectively.The detection rate of microcalcification with the two methods was 81.05%（77/95） and 12.63%（12/95,P〈0.001）,respectively.ConclusionMammography is superior on detection of microcalcifications,while US is better in detecting masses.The combined modalities can improve the sensitivity in diagnosis of DCIS.

关 键 词：原位癌 乳房X线摄影术 超声检查 诊断 乳腺肿瘤 

分 类 号：R737.9[医药卫生—肿瘤] R445[医药卫生—临床医学]