乳腺MRI简化序列与全数字化乳腺X线摄影、乳腺MRI全序列在非钙化表现早期乳腺癌诊断中的价值  

The value of breast MRI-abbreviated protocol with full field digital mammography and breast MRI-full diagnostic protocol in the diagnosis of early breast cancer with non-calcified manifestations

作　　者：张冬雪 张水岚 丁莹莹[1] 李卓琳[1] ZHANG Dongxue;ZHANG Shuilan;DING Yingying;LI Zhuolin(Department of Radiology,Yunnan Cancer Hospital,Kunming 650000,China)

机构地区：[1]云南省肿瘤医院放射科,云南昆明650000

出　　处：《实用放射学杂志》2024年第4期567-571,共5页Journal of Practical Radiology

摘　　要：目的探讨乳腺磁共振成像简化序列(BMRI-AP)与全数字化乳腺X线摄影(FFDM)、乳腺磁共振成像全序列(BMRI-FDP)相比,在非钙化表现早期乳腺癌诊断中的价值。方法回顾性纳入非钙化表现早期乳腺癌患者(病灶最长径≤2 cm,原位癌则不论大小)95例,收集患者的临床、病理及影像学资料。所有患者均行FFDM、MRI检查,得到FFDM、BMRI-AP、BMRI-FDP 3种检查方案。根据美国放射学会(ACR)制定的乳腺影像报告和数据系统(BI-RADS)分类标准(第5版)进行分类,以病理结果为标准,比较不同影像学方法对非钙化表现早期乳腺癌的诊断效能。结果FFDM、BMRI-AP、BMRI-FDP对非钙化表现早期乳腺癌诊断准确率分别为76.84%、93.68%、95.79%,差异有统计学意义(χ^(2)=20.558,P<0.001)。BMRI-AP、BMRI-FDP扫描时间中位数(四分位距)分别为478(5)s、926(13)s,差异有统计学意义(Z=-11.912,P<0.001)。结论对非钙化表现早期乳腺癌,BMRI-AP诊断准确率明显优于FFDM检查,与BMRI-FDP相当。此外,BMRI-AP在未降低诊断准确率的前提下,明显缩短扫描时间,有望成为一种新的乳腺癌筛查方式。Objective To investigate the value of breast MRI-abbreviated protocol(BMRI-AP)compared with full field digital mammography(FFDM)and breast MRI-full diagnostic protocol(BMRI-FDP)in the diagnosis of early breast cancer with non-calcified.Methods A total of 95 cases patients with early breast cancer with non-calcified(the longest diameter of the lesion≤2 cm,regardless of the size of the carcinoma in situ)were retrospectively included.Clinical,pathological and imaging data of all patients were collected.All patients underwent FFDM and MRI scanning,and three examination regimens,including FFDM,BMRI-AP,BMRI-FDP,were further obtained.Classification was performed according to the breast imaging reporting and data system(BI-RADS)classification standard(fifth edition)developed by American College of Radiology(ACR),and pathological results were taken as the standard.The diagnostic efficacy for early breast cancer with non-calcified were compared among the different three imaging methods.Results The diagnostic accuracy of FFDM,BMRI-AP and BMRI-FDP for early breast cancer with non-calcified was 76.84%,93.68%and 95.79%,respectively,with statistically significant difference among three groups(χ^(2)=20.558,P<0.001).The median(quartile distance)of BMRI-AP and BMRI-FDP scanning time were 478(5)s and 926(13)s,respectively,with statistically significant difference between the two groups(Z=-11.912,P<0.001).Conclusion The diagnostic accuracy of BMRI-AP is significantly better than that of FFDM and similar to that of BMRI-FDP for early breast cancer with non-calcified.In addition,BMRI-AP can significantly shorten the scanning time without reducing the diagnostic accuracy,which is expected to become a new breast cancer screening method.

关 键 词：乳腺肿瘤 全数字化乳腺X线摄影 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R816.4[医药卫生—临床医学] R445.2