动态增强MRI在乳腺X线摄影检出BI-RADS 4～5级微钙化病变的价值  

The Value of Contrast-Enhanced Breast MRI in Patients with BI-RADS 4-5 Microcalifications on Mammography

作　　者：陈佳儿 肖莹[1] 江红[1] 李仰康[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院放射科

出　　处：《临床放射学杂志》2018年第2期222-226,共5页Journal of Clinical Radiology

摘　　要：目的探讨动态增强MRI对乳腺X线摄影检出BI-RADS 4-5级微钙化病变的价值。方法回顾性分析乳腺X线摄影检出BI-RADS 4-5级的75例患者资料,共81个病灶,均完成双乳动态增强MRI检查。按BIRADS进行分级,以术后病理为金标准,计算两种检查方法的敏感度、特异度、准确率、阳性预测值（PPV）,并用卡方检验进行比较。结果 81个病灶中包括恶性病变63个,良性病变18个,乳腺X线摄影和MRI的敏感度、特异度、准确率、PPV分别为100%、0、77.8%、77.8%及98.3%、88.9%、96.3%、98.4%,两种检查方法的敏感度无统计学差异（P=0.496）,特异度、准确率、PPV差异均有统计学意义（P均〈0.05）。结论对乳腺X线摄影检出的BI-RADS 4-5级微钙化病变,动态增强MRI能有效地提高定性诊断的准确率,避免不必要的活检。Objective To discuss the value of contrast-enhanced breast MRI in patients with BI-RADS 4-5 microcalifications on mammography. Methods Seventy-five patients with BI-RADS 4-5 microcalifications on mammography including 81 lesions were retrospectively analyzed. All of the patients went through the contrast-enhanced breast MRI and compared with pathological results. The diagnostic value of mammography and MRI was compared. Results Of the 81 lesions,pathologic examination revealed 63 malignant lesions and 18 benign lesions. The sensitivity,specificity,accuracy,PPV of mammography was 100% 、0% 、77. 8% 、77. 8%,whereas those for MR was 98. 3%（ P = 0. 496） 、88. 9%（ P 0. 01） 、96. 3%（ P〈0. 01） 、98. 4%（ P 0. 01）. Of the 44 category 4 lesions,mammography had a sensitivity of 100%,a specificity of 0%,an accuracy of 61. 4%,a PPV of 61. 4%,whereas MRI had a sensitivity of 100%（ P ﹥ 0. 05） 、a specificity of 94. 1%（ P〈0. 01） 、an accuracy of 97. 7%（ P〈0. 01） and a PPV of 96. 4%（ P〈0. 01）. Of the 37 category 5 lesions,The sensitivity,specificity,accuracy,PPV of mammography was 100% 、0% 、61. 4% 、61. 4%,respectively whereas the corresponding values for MR was 97. 2% 、0% 、94. 6% 、97. 2%. All of them had not significant statistical significance（ P ﹥ 0. 05）. Conclusion Contrast-enhanced breast MRI can effectively improve the accuracy of qualitative diagnosis in patients with BI-RADS 4-5 microcalifications on mammography and avoid unnecessary biopsies.

关 键 词：乳腺X线摄影 微钙化 MRI 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.44[医药卫生—诊断学] R737.9[医药卫生—临床医学]