乳腺MRI、超声以及X线三者联合在乳腺疾病诊断及乳腺癌术式选择中的作用  

The Role of Combined Breast MRI,Ultrasound and X-ray in the Diagnosis of Breast Disease and the Choice of Breast Cancer Surgery

作　　者：李莹 徐向阳 周瑞[2] 程明强 LI Ying;XU Xiang-yang;ZHOU Rui;CHENG Ming-qiang(Department of Radiology,Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430077,Hubei Province,China;Department of Thyroid Breast Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430062,Hubei Province,China;Department of Surgery,Anlu Second People's Hospital,Anlu 432600,Hubei Province,China)

机构地区：[1]华中科技大学同济医学院附属梨园医院放射科,湖北武汉430077 [2]武汉大学中南医院甲状腺乳腺外科,湖北武汉430062 [3]安陆市第二人民医院外科,湖北安陆432600

出　　处：《中国CT和MRI杂志》2024年第4期76-79,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨乳腺MRI、超声及乳腺X线在乳腺疾病诊断及乳腺癌手术方式选择中的临床应用价值。方法2019年1月至2020年1月入院的乳腺疾病患者作为研究对象,130例乳腺疾病患者术前均行乳腺MRI、超声及乳腺X线评估乳腺病变,127例乳腺癌患者同时行乳腺MRI及乳腺超声,以评估腋窝淋巴结,进一步确定手术方式。结果三项检查联合运用在乳腺疾病诊断中的敏感性、特异性以及准确性分别为98.51%、98.41%及98.46%。在诊断乳腺结节敏感性方面,三项联合诊断虽高于单用超声、X线及MRI,但统计无显著性差异;而在特异性方面,三项联合诊断高于单用超声及X线,统计有显著性差异;MRI检查的敏感性、特异性和准确性均高于超声及X线检查,分别为97.01%、90.48%和93.85%。超声及MRI二者联合诊断对腋窝淋巴结的敏感性,特异性和准确性分别为94.00%,97.40%及96.06%。二者联合诊断的敏感性、特异性、准确性同单项相比,无统计学差异,说明超声和MRI评估腋窝淋巴结都有一定的优势。结论乳腺MRI、超声和乳腺X线三项检查联合在对乳腺疾病的诊断和腋窝淋巴结转移的评估有较高的准确性,三项检查各有优缺点,适当完美组合有助于手术方法的选择。Objective To investigate the clinical application value of breast MRI,ultrasound and mammography in the diagnosis of breast disease and the selection of surgical modality for breast cancer.Methods Patients with breast disease admitted from January 2019 to January 2020 were used as study subjects.130 patients with breast disease underwent preoperative breast MRI,ultrasound and mammography to evaluate breast lesions,and 127 patients with breast cancer underwent both breast MRI and breast ultrasound to evaluate axillary lymph nodes and further determine the surgical approach.Results The sensitivity,specificity and accuracy of the combined use of the three tests in the diagnosis of breast disease were 98.51%,98.41%and 98.46%,respectively.The sensitivity,specificity and accuracy of MRI were higher than those of ultrasound and X-ray alone,with 97.01%,90.48%and 93.85%,respectively.The sensitivity,specificity and accuracy of combined ultrasound and MRI for axillary lymph nodes were 94.00%,97.40%and 96.06%,respectively.The sensitivity,specificity,and accuracy of the combined diagnosis were not statistically different compared with those of the individual items,indicating that both ultrasound and MRI have certain advantages in the assessment of axillary lymph nodes.Conclusion The combination of breast MRI,ultrasound and mammography has high accuracy in the diagnosis of breast disease and the assessment of axillary lymph node metastasis,and each of the three examinations has its own advantages and disadvantages.

关 键 词：乳腺X线 彩色多普勒超声 MRI 保乳 

分 类 号：R81[医药卫生—放射医学]