B超、钼靶X线及MRI对乳腺癌密度分级的对比研究  

Comparative Study on the Density of Breast Cancer by Ultrasound, Mammography and MRI

作　　者：管燕[1,2] 毛有胜[3] 欧阳伊雯 潘悦[3] 罗雪莹[3] 陈伟财[3] 何劲松[3] 

机构地区：[1]广州医科大学,广东广州510180 [2]深圳市第三人民医院,广东深圳518000 [3]深圳市第二人民医院,广东深圳518035

出　　处：《深圳中西医结合杂志》2015年第21期1-4,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：广东省科技计划项目(2013B021800096);深圳市科技计划国际合作项目(GJHZ20140414170821180)

摘　　要：目的:探讨B超、钼靶X线和磁共振成像(MRI)对乳腺癌密度分级的表现,比较3种影像学检查手段对乳腺癌诊断的价值。方法:回顾性分析2010年1月至2015年1月的5年间,深圳市第二人民医院经临床触诊检查怀疑乳腺癌病例共156例均行B超、乳腺钼靶、MRI检查,以乳腺影像报告和数据系统(BI-RADS)分类为Ⅲ类、Ⅳ类及Ⅴ类。比较三者对恶性征象肿块的检出率和微钙化(microcalcication)的敏感性,以及三者联合应用对乳腺癌诊断率的差异。结果:156例通过病理检查诊断为乳腺癌的患者共143例,MRI、乳腺钼靶和彩超对早期乳腺癌的检出率、灵敏度分别为92.3%和84.6%;83.9%和76.9%;79.7%和73.1%。B超、乳腺钼靶和MRI 3种检查手段联合应用与其分别单独使用的诊断结果比较,差异具有统计学意义(P<0.05)。结论:B超和钼靶可组成黄金搭档,作为早期乳腺癌筛查的首选检查手段。在上述3种检查方法中MRI诊断早期乳腺癌的敏感性为最佳,但特异性最差。而MRI+B超+钼靶3种方法联合诊断可显著提高特异性。Objective To investigate the density classifi cation of breast cancer by B ultrasound, X-ray mammography and MRI, and to compare the value of these three imaging methods for breast cancer diagnosis. Methods A retrospective analysis of total 156 cases of suspected breast cancer clinical palpation which all examined by ultrasonography, mammography and MRI in Shenzhen Second People＇s Hospital in 5 years from January 2010 to January 2015, according to the Breast Imaging Reporting and Data System（BI-RADS）, were classifi ed as Class Ⅲ, Ⅳ and Ⅴ. Comparing the diagnostic rate of malignant signs and the sensitivity of micro calcifi cation of these three Imagine methods, as well as differences in the breast cancer diagnosis with three methods combined. Results In total 156 cases of breast cancer diagnosed by pathological examination, 143 cases is pathologically diagnosed as breast cancer, the detection rate and sensitivity of MRI, mammography and color Doppler ultrasound for early breast cancer were 92.3 % and 84.6 %, 83.9 % and 76.9%; 79.7 % and 73.1% respectively. The differences between the diagnostic results by ultrasonography, breast molybdenum target and MRI respectively, and by three examination methods combined were statistically significant（P〈0.05）. Conclusion B ultrasound and molybdenum target can be composed of gold partner, as the first choice for early breast cancer screening. The sensitivity of MRI in the diagnosis of early breast cancer was the best, but the specifi city was the worst in the three methods. The combination of MRI、B ultrasound and molybdenum target X-ray can signifi cantly improve the specifi city.

关 键 词：乳腺癌 B超 钼靶X线摄影 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤]