多模态影像技术在早期乳腺癌诊断中的对比研究  

Comparison of the diagnostic efficiency for breast neoplasms using multiple imaging diagnostic technology

作　　者：杨勇[1] 杨一林[1] 吕秀花[1] 王臻[1] 袁丽君[1] 段云友[1] 

机构地区：[1]第四军医大学唐都医院超声科,西安710038

出　　处：《中华超声影像学杂志》2016年第7期603-607,共5页Chinese Journal of Ultrasonography

摘　　要：目的比较超声检查技术（光散射成像、弹性成像、超声造影）、钼靶、磁共振以及多种影像联合在乳腺癌诊断中的价值。方法利用超声检查（光散射、弹性、造影）、钼靶和磁共振分别检查75例乳腺病灶，与术后病理结果对比，比较各诊断方法的敏感性、特异性、阳性预测值和阴性预测值．对各方法行Kappa一致性检验。结果超声造影、磁共振和5种成像方式联合使用（即超声新技术＋钼靶＋磁共振）的敏感性和阴性预测值（92．31％，90．63％；94．87％，92．86％；97．44％，96．15％）均优于钼靶（74．36％，71．43％），差异有统计学意义（P〈0．05）；超声造影与超声联合成像的敏感性一致，均为92．31％，略高于弹性成像和光散射成像，差异无统计学意义（P〉0．05），但与钼靶比较差异有统计学意义（P〈0．05）；对各影像诊断行Kappa一致性检验，光散射成像、弹性成像、超声造影、超声联合、钼靶、磁共振及所有联合成像的Kappa值分别为0．678、0．624、0．732、0．705、0．439、0．677、0．676。结论各种影像诊断在乳腺疾病的诊断中各有优势，超声造影、磁共振以及各影像检查的联合应用在乳腺癌的诊断中具有重要临床价值。Objective To compare the respective diagnostic efficiency for breast cancer with ultrasound diffusion optical imaging （ DOI）, ultrasonic elastography （UE）, contrast-enhanced ultrasound （CEUS）, X-ray mammography（XRM）, magnetic resonance imaging （MRI）, and combinations of these imaging modalities. Methods Seventy-five breast lesions were collected. These lesions were confirmed by surgery and histopathology. All of breast lesions were examined ultrasound, mammography and enhanced- MRI examinations before surgical excision. The specificity, sensitivity, positive predictive value and negative predictive value of each modality were compared. Results The sensitivities and the diagnostic negative predictive values for MRI ＋ US ＋ XRM （97.44%, 96.15%）, CEUS （92.31%, 90.63%） and MRI （94.87%,92.86%） were significantly higher than those for XRM （74.36%, 71.43%）, respectively. The sensitivity for DOI ＋ CEUS ＋ UE was the same as one for CEUS, they were not significantly higher than those for UE and DOI （ P 〈0.05）, while they were significantly higher than that for XRM （ P 〈0.05）. The kappa values for DOI, UE, CEUS, USG（UE ＋ DOI ＋ CEUS）, XRM, MRI and MRI ＋ US ＋ XRM were 0.678, 0.624, 0.732, 0.705, 0.439, 0.677 and 0.676, respectively. Conclusions Different imaging modalities have themselves advantages to diagnose malignant or benign lesions. CEUS, MRI and combinations of these imaging modalities have highly important clinical values in breast disease diagnosis.

关 键 词：乳腺肿瘤 超声检查 钼靶 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤]