乳腺X线摄影与MRI对乳腺原发局部结构扭曲伴微小钙化病变诊断价值的对比研究  

Comparative study of mammography and MRI in the diagnosis of primary architectural distortion with microcalcification

作　　者：司丽芳[1] 刘小娟[1] 杨开颜[1] 王丽[1] 蒋涛[1] 翟仁友[1] 

机构地区：[1]首都医科大学附属北京朝阳医院放射科,北京100020

出　　处：《实用放射学杂志》2015年第12期1956-1959,1991,共5页Journal of Practical Radiology

摘　　要：目的 探讨乳腺X线摄影与MRI对乳腺原发局部结构扭曲伴微小钙化病变的诊断价值,以及微小钙化形态特点与病变良恶性的关系。方法 回顾性分析56例（57个病变）行全视野数字化乳腺X线摄影（FFDM）且显示为局部结构扭曲病变并行MRI检查的患者资料，将其分为伴微小钙化病变和不伴钙化病变，以病理结果或2年随访观察结果为金标准，分别统计动态增强MRI（DCE-MRI）及FFDM对2类病变诊断的敏感性、特异性。结果 良性病变29个，恶性病变28个；伴钙化病变33个，不伴钙化病变24个。DCE-MRI对局部结构扭曲伴微小钙化病变诊断的敏感性与FFDM相同（87.5%），特异性较FFDM显著提高（58.8% vs 17.6%，P=0.032 4）；对不伴钙化病变诊断的敏感性二者无统计学差异（P=0.068 6），特异性有显著提高（0 vs 41.7%，P=0.037 3）。点状钙化多出现在良性病变中（P=0.006 6），而其他钙化类型在良恶性病变分布上无统计学差异。结论 DCE-MRI较FFDM对于原发局部结构扭曲伴或不伴微小钙化病变均有较高的鉴别诊断价值。Objective To evaluate the value of mammography and dynamic contrast-enhanced MRI （DCE-MRI） in the diagnosis of primary architectural distortion lesions with calcification detected by mammography,and to evaluate the characteristics of the calcification shape of malignant and benign leisions. Methods The full-field digital mammography （FFDM） images and DCE-MRI of 57 lesions with architectural distortion in 56 patients were retrospectively reviewed. The lesions were classified based on the lesions with orwithout microcaleification. The pathological results or the two-year follow up findings were set as golden standard. We investigated the sensitivity and specificity of FFDM and DCE-MRI in the diagnosis of lesions with or without microcalcification. Results Of the 57 lesions,28 were malignant and 29 were benign. Among these lesions,33 were with microcalcification while 24 were without microcalcification. DCEMRI showed the higher specificity（ 58.8 % vs 17.6%, P = 0. 032 4）and equal sensitivity （87.5 %）when compared to FFDM in lesions with microcalcification. In lesions without microcalcification,DCE MRI showed higher specificity （0 vs 41.7%,P=0. 037 3）than that of FFDM,while the sensitivity showed no significant statistical differences （P= 0. 068 6 ） between the two groups. The calcification shape showed no difference between benign and malignant lesions except for punctuate calcification. Punctate calcification was more commonly seen in benign lesions（P=0. 006 6）. Conclusion DCE-MRI is very helpful to differentiate malignant from benign in lesions that FFDM manifested primarily architectural distortion,independent of whether the lesion is with or without calcification.

关 键 词：乳腺X线摄影 磁共振成像 局部结构扭曲病变 

分 类 号：R655.8[医药卫生—外科学] R814.41[医药卫生—临床医学]