二次超声对MRI所见乳腺高危病灶诊断价值及病变特征探讨  

The Diagnostic Value and Lesion Characteristics Discussion of Second-look Ultrasound for High Risk Breast Lesions Detected by MRI

作　　者：张楠[1] 秦王燕[1] 常洪晶 王心怡[1] 马洁玲 何英剑[1] 霍苓[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所乳腺癌预防治疗中心,恶性肿瘤发病机制及转化研究教育部重点实验室,北京市100142

出　　处：《中国超声医学杂志》2017年第3期209-212,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨二次超声对MRI所见乳腺高危病灶的诊断价值及病变特征。方法对首次超声未显示,但乳腺MRI检查提示BI-RADS 4级及以上的高危病灶进行二次超声对比分析,以病理诊断为"金标准",分析病灶的MRI、超声影像特征,探讨二者协诊价值。结果二次超声可见病灶与MRI所见病灶的比例38/48(79%),恶性病变占病理证实为恶性的比例28/29(97%);良性比例10/19(53%)。二次超声发现病变为恶性的比例为28/38(74%),二次超声未发现病变但最后病理证实为恶性的比例1/10(10%)。二次超声检测出的28个恶性病变与超声病变边缘显著相关(P<0.001)。结论结合MRI的二次超声灵敏度好,可以提高恶性病变的检出率。MRI与超声的肿块型、非肿块型病变匹配程度越高,预测能力越好。掌握病变的超声影像学特征,可以避免误诊,减少漏诊。Objective To explore the diagnostic value and lesions characteristics of second-look ultrasonography （US） in evaluating high-risk lesions detected on MRI. Methods Pathologic diagnosis as the gold standard, the MRI, US data of high-risk lesions were retrospectively reviewed. Their diagnostic performance and imaging features were analyzed. Results Second-look US identified 38/48 （79~） of the high-risk lesions revealed by MRL A US correlate was seen in 28/29 （97~） malignant lesions compared with 10/19 （53~） benign lesions. The likelihood of malignancy was significantly higher for High-Risk lesions with a US correlate than lesions without： 28/38 （74%） versus 1/10 （10%）. The malignancy of the 28 lesions were significantly associated with US lesion margins （P〈0. 001）. Conclusions Secon＆look US combined with MRI have high sensitivity, and can improve the detection rate of malignant le sions. Familiarity with the US features associated with malignancy could avoid and reduce the rate of misdiagnose.

关 键 词：乳腺 MRI 二次超声 

分 类 号：R445[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]