磁共振成像与乳房X线摄影对乳腺簇状钙化病变的诊断价值比较  

Comparison of magnetic resonance imaging and mammography for the diagnosis of cluster calcification of breast lesions

作　　者：马金平 朱荔 刘紫朦 杨丽[1,3] 刘丰源[1] 鲍宝石 邢宁 王建东[1] Ma Jin-Ping;Zhu Li;Liu Zi-Meng;Yang Li;Liu Feng-Yuan;Bao Bao-Shi;Xing Ning;Wang Jian-Dong(Department of General Surgery,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of General Surgery,Yantai Penglai People's Hospital,Yantai,Shandong 265600,China;Department of General Surgery,Beijing Shunyi Hospital,Beijing 101300,China)

机构地区：[1]解放军总医院第一医学中心普通外科医学部,北京100853 [2]烟台市蓬莱人民医院普外一科,山东烟台265600 [3]北京市顺义区医院普通外科,北京101300

出　　处：《解放军医学杂志》2022年第1期53-57,共5页Medical Journal of Chinese People's Liberation Army

摘　　要：目的比较磁共振成像(MRI)与乳房X线摄影(MG)对乳腺簇状钙化病变的诊断价值。方法回顾性分析2009年1月-2018年5月于解放军总医院就诊的62例乳腺簇状钙化病变患者的影像学和病理资料。以术后病理结果为诊断金标准,比较MRI与MG对乳腺簇状钙化病变的诊断效能及对肿块样病变的检出能力。结果术后病理结果显示,62例簇状钙化病变中,良性20例,恶性42例。MRI检查诊断为1-3类14例(22.6%),4类11例(17.7%),5类37例(59.7%);MG检查诊断为1-3类10例(16.1%),4类30例(48.4%),5类22例(35.5%)。MRI与MG检查的诊断一致性较差,Kappa值为0.346。MRI的诊断效能(AUC=0.940,95%CI 0.850~1.000)高于MG(AUC=0.800,95%CI 0.686~0.914)。MRI诊断的敏感度、准确率、阳性预测值、阴性预测值分别为85.7%、88.7%、97.3%、76.0%,均高于MG(分别为50.0%、64.5%、95.5%、47.5%)。结论对于乳腺簇状钙化病变,MRI的诊断价值较MG高。Objective To evaluate the diagnostic value of magnetic resonance imaging (MRI) and mammography (MG) in clustered calcification of breast lesions.Methods The imaging and pathological data of 62 patients with clustered calcification breast lesions in the Chinese PLA General Hospital was retrospectively analyzed to compare the diagnostic efficacy of MRI and MG.Results Of 62 clustered calcification lesions,20 were benign according to pathologic result,and 42 were malignant.In MRI examination,14 cases (22.6%) were classified as 1-3,11 cases (17.7%) as 4,and 37 cases (59.7%) as 5.In MG examination,10 cases (16.1%) were classified as 1-3,30 cases (48.4%) as 4,and 22 cases (35.5%) as 5.The consistency between MRI and MG was poor (Kappa=0.346).The diagnostic efficacy of MRI (AUC=0.940,95%CI 0.850-1.000) was higher than that of MG (AUC=0.800,95%CI 0.686-0.914),and the sensitivity,accuracy,positive predictive value,negative predictive value of MRI (85.7%,88.7%,97.3%,76.0%) were higher than those of MG (50.0%,64.5%,95.5%,47.5%).Conclusion For clustered calcification of breast lesions,the diagnostic value of MRI is higher than that of MG.

关 键 词：簇状钙化 乳腺 磁共振成像 乳房X线摄影 

分 类 号：R737.9[医药卫生—肿瘤]