彩色多普勒超声、钼靶X线摄影与磁共振成像在触诊阴性乳腺癌诊断中的应用价值对比  

Comparison of color Doppler ultrasonography,mammography and nuclear magnetic resonance imaging in the diagnosis of breast cancer

作　　者：万江花[1] 王富天 李丹娜 洪莲 林娟[1] 邓丹琼[1] 

机构地区：[1]海南医学院第一附属医院放射科,海南海口570102 [2]海南医学院医学影像系,海南海口570102 [3]海南医学院第一附属医院超声科,海南海口570102

出　　处：《现代医学》2017年第12期1813-1818,共6页Modern Medical Journal

基　　金：海南医学院2016年国家级大学生创新创业训练计划项目(201611810051)

摘　　要：目的:对比彩色多普勒超声、钼靶X线摄影与磁共振成像(MRI)在触诊阴性乳腺癌诊断中的应用价值。方法:选择2011年9月至2017年12月因乳房胀痛、乳腺肿块等症状来我院就诊的触诊阴性乳腺癌患者91例,病理诊断为恶性病灶患者(恶性组)30例和良性病灶患者(良性组)61例,记录所有患者的彩色多普勒超声、钼靶X线摄影与MRI诊断特征,判定三种诊断方式的诊断价值。结果:钼靶X线在恶性组的患者中,多可见微小钙化的致密乳腺腺体,有肿块影,其边缘可见毛刺征,与良性组对比差异明显(P<0.05)。恶性组中MRI BI-RADS分级中Ⅰ型曲线1例,Ⅱ型曲线2例,Ⅲ型曲线8例,Ⅳ型曲线19例;良性组中分别为30例、27例、2例和2例两组对比差异有统计学意义(P<0.05)。钼靶X线摄影判定为恶性病灶33例,良性病灶58例;彩色多普勒超声判定为恶性病灶35例,良性病灶56例;MRI判定为恶性病灶32例,良性病灶59例。为此彩色多普勒超声、钼靶X线摄影与MRI在触诊阴性乳腺癌诊断中的敏感性与特异性分别为88.5%、93.3%、88.5、86.7%、96.7%和100.0%。结论:彩色多普勒超声、钼靶X线摄影与MRI在触诊阴性乳腺癌诊断中的应用都有比较好的价值,在临床诊断中可三者结合使用,从而提高乳腺癌的诊断效果。Objective： To compare the diagnostic value of color Doppler ultrasonography,mammography and magnetic resonance imaging（ MRI） in the diagnosis of negative breast cancer. Methods： From September 2011 to December 2017,91 patients with nonpalpable breast cancer due to breast pain,breast lumps and other symptoms in our hospital were selected,including 30 patients with malignant tumors（ malignant group） and 61 patients of benign lesions（ benign group）, their diagnostic features of all patients with color Doppler ultrasound,mammography and MRI were recorded. Results： Compared with the benign group,mammography in the malignant group mostly showed dense glands,tiny calcification,marginal edge burr and mass image（ P〈 0. 05）. In the malignant group,1 patient had MRI BI-RADS,2 patients type Ⅱ curve,8 patients type Ⅲ curve,19 patients typeⅣ curve. while correspondingly 30 patients had typeⅠcurve,27 patients type Ⅱ curve,2 patients type Ⅲ curve and 2 patients type Ⅳ curve in the benign group,and the difference between the two groups being statistically significant（ P〈 0. 05）. Mammography turned out 33 patients of malignant lesions,58 benign lesions; color Doppler ultrasound determined in 35 malignant lesions,56 benign lesions; MRI determined 32 patients with malignant lesions,59 benign lesions,The sensitivity and specificity of color Doppler ultrasound,mammography and MRI in the diagnosis of breast cancer were 88. 5%,93. 3%,88. 5%,86. 7%,96. 7% and 100. 0%. Conclusion：Color Doppler ultrasound,mammography and MRI in the diagnosis of nonpalpable breast cancer have relatively good effect,however a Combined use of the three methods can improve the effect of diagnosis of breast cancer.

关 键 词：彩色多普勒超声 诊断价值 钼靶X线摄影 乳腺癌 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R445[医药卫生—临床医学]