MRI评估钼靶X线BI-RADS1-2类假阴性乳腺癌研究  

MRI Evaluation of Mammogram X-ray BI-RADS Class 1~2 False Negative Breast Cancer Study

作　　者：杨云美 丁俞江 祁伟罡 邵清[2] Yang Yunmei;Ding Yujiang;Qi Weigang;Shao Qing(Department of Radiology,Pudong New Area People's Hospital,Shanghai Pudong 201299;Department of Oncology,Jiangyin People's Hospital,Jiangyin 214400,Jiangsu)

机构地区：[1]上海市浦东新区人民医院放射科,上海浦东201299 [2]江阴市人民医院肿瘤科,江苏江阴214400

出　　处：《现代科学仪器》2021年第6期160-164,共5页Modern Scientific Instruments

基　　金：江阴市科研计划项目:MS201532。

摘　　要：目的:探究磁共振成像(MRI)评估X线钼靶摄影诊断为乳腺影像报告和数据系统(BI-RADS)1~2类假阴性乳腺癌的临床价值。方法:连续性收集我院2018年6月至2020年6月经病理证实为乳腺癌但X线钼靶摄影检查定为BI-RADS 1类或2类41例患者(假阴性组),此外选择同期经病理证实为乳腺癌且X线钼靶摄影检查诊断为BI-RADS 4C或5类患者70例(对照组)。受试者均于X线钼靶摄影检查后1周内行乳腺MRI扫描。比较两组乳腺癌的MRI特征。结果:假阴性组病灶平均最大径明显小于对照组[(13.6±5.3)mm vs(20.4±5.9)mm,t=6.079,P<0.001];假阴性组乳腺多腺体多为多量腺体型和致密型,对照组四种腺体类型分布相对均衡;假阴性组病灶多为早期均匀强化,对照组为不均匀强化和环形强化,两组乳腺癌MRI增强扫描强化特点比较,差异具有统计学意义(均P<0.05);对照组DWI高信号占比明显高于假阴性组[88.6%(62/70)vs 61.0%(25/41),x^(2)=11.619,P<0.001];两组乳腺癌MRI增强扫描病灶边缘均主要为毛刺、分叶及分叶+毛刺等,且MRI动态增强的时间-信号强度曲线(TIC)类型分布无显著差异(P>0.05)。结论:乳腺癌钼靶X线假阴性病例的MRI表现具有一定的特征性,可较好地弥补乳腺癌钼靶X线检查缺陷,提高诊断效率。Objective:To explore the clinical value of magnetic resonance imaging(MRI)in the diagnosis of breast imaging reporting anddata system(BI-RADS)1~2 type false negative breast cancer by X-ray mammography.Method:From June 2018 to June 2020,41 patients with breast cancer confirmed by pathology but diagnosed as BI-RADS 1~2 type by X-ray mammography(false negative group)were collected.At the same time,70 patients with breast cancer confirmed by pathology and diagnosed as BI-RADS 4C or 5 type by X-ray mammography(control group)were selected.All underwent breast MRI scan within 1 week after mammography.The MRI features of breast cancer were compared between the two groups.Results:The average maximum diameter of lesions in the false negative group was significantly smaller than that in the control group[(13.6±5.3)mm vs(20.4±5.9)mm,T=6.079,P<0.001];In the false-negative group,the mammary glands were mostly of multiple glandular type and dense type,while in the control group,the distribution of the four glandular types was relatively balanced;The lesions in the false-negative group were mainly early-stage uniform enhancement,while in the control group were mainly uneven enhancement and ring enhancement.The enhancement characteristics of MRI enhanced scan of breast cancer in the two groups were significant differences(all P<0.05);The proportion of high DWI signal in the control group was significantly higher than that in the fals-negative group[88.6%(62/70)vs 61.0%(25/41),x2=11.619,P<0.001];The edge of breast cancer lesions on enhanced MRI scan of the two groups were mainly burrs,lobules and lobules+burrs,etc.,and there was no significant difference in the time-signal intensity curve(TIC)distribution of dynamic enhancement of MRI(P>0.05).Conclusion:The MRI performance of breast cancer patients with false negative mammography has certain characteristics,which can make up for the defect of breast cancer mammography and improve the diagnostic efficiency.

关 键 词：乳腺癌 磁共振成像 X线钼靶摄影 乳腺影像报告和数据系统 假阴性 

分 类 号：R73[医药卫生—肿瘤]