多模态MRI对乳腺X线摄影非肿块病变的诊断价值  

Diagnostic Value of Multi-modality MRI in Non-mass Lesions of Mammography

作　　者：黄瑞岁[1] 赵沁萍 丁可[1] 李秋萍 陈江 曾雪梅 HUANG Rui-sui;ZHAO Qin-ping;DING Ke;LI Qiu-ping;CHEN Jiang;ZENG Xue-mei(Department of Radiology,the Second People's Hospital of Nanning,Nanning 530031,Guangxi,China)

机构地区：[1]南宁市第二人民医院放射科,广西南宁530031

出　　处：《医学信息》2020年第8期84-86,91,共4页Journal of Medical Information

基　　金：南宁市医学重点学科建设项目〔编号:南卫[2017]11号〕。

摘　　要：目的探讨多模态MRI成像对乳腺X线摄影非肿块病变的诊断价值。方法收集2018年1月~2019年8月我院行乳腺X线摄影检查诊断为非肿块类病变,经手术或活检病理证实为乳腺疾病的68例患者临床资料,患者均行常规平扫、动态增强扫描(DCE)和扩散加权成像(DWI)等乳腺MRI检查,依据乳腺影像报告和数据系统(BI-RADS)标准对X线和MRI表现进行分析和评估,以病理诊断为金标准,计算两种检查方法诊断病变的敏感度、特异度和准确度并比较。结果病理结果示68例患者共有83个病灶,恶性病灶37个,良性病灶46个。乳腺X线摄影检出病灶75个,检出率为90.36%;其诊断恶性病灶35个,良性病灶40个,正确诊断恶性病灶28个,良性病灶32个,诊断的敏感度、特异度和准确度分别为77.78%、82.06%和80.00%。MRI检出病灶81个,检出率为97.59%;其诊断恶性病灶39个,良性病灶42个,正确诊断恶性病灶36个,良性病灶40个,诊断的敏感度、特异度和准确度分别为94.74%、93.03%和93.83%。乳腺X线摄影与MRI检查诊断非肿块病变的敏感度和准确度比较,差异有统计学意义(P<0.05),两种方法特异度比较,差异无统计学意义(P>0.05)。结论与乳腺X线摄影比较,多模态MRI成像不但能提高病变的检出率,还可提高非肿块病变诊断的敏感度和准确度,为良恶性病变的鉴别提供更多的影像学支持。Objective To explore the diagnostic value of multimodal MRI imaging in non-mass lesions of mammography.Methods Collected clinical data of 68 patients diagnosed as non-mass lesions by mammography in our hospital from January 2018 to August 2019,and confirmed to be breast disease by surgery or biopsy.All patients underwent routine plain scan and dynamic enhancement Breast MRI examinations such as scan(DCE)and diffusion weighted imaging(DWI),analyze and evaluate the X-ray and MRI performance according to the breast imaging report and data system(BIRADS)standard,with pathological diagnosis as the gold standard examination method diagnoses the sensitivity,specificity and accuracy of the lesion and compares.Results The pathological results showed that 68 patients had 83 lesions,37 malignant lesions,and 46 benign lesions.Mammography detected 75 lesions with a detection rate of 90.36%;it diagnosed 35 malignant lesions,40 benign lesions,28 correctly diagnosed malignant lesions,and32 benign lesions.The degrees were 77.78%,82.06%and 80.00%,respectively.MRI detected 81 lesions with a detection rate of 97.59%;its diagnosis was 39 malignant lesions,42 benign lesions,36 correctly diagnosed malignant lesions,and 40 benign lesions.The sensitivity,specificity and accuracy of the diagnosis were:94.74%,93.03%and 93.83%,the difference between the sensitivity and accuracy of mammography and MRI in the diagnosis of non-mass lesions was statistically significant(P<0.05).The specificity comparison between the two methods was not statistically significant(P>0.05).Conclusion Compared with mammography,multimodal MRI imaging can not only improve the detection rate of lesions,but also improve the sensitivity and accuracy of the diagnosis of non-mass lesions,and provide more imaging support for the differentiation of benign and malignant lesions.

关 键 词：磁共振成像 乳腺X线摄影 乳腺肿瘤 BI-RADS 

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