乳腺结构扭曲病变的综合影像诊断与对比研究  

Comprehensive imaging diagnosis and comparative study of breast architectural distortion lesions

作　　者：柏玉涵[1] 杨健[2] 宋之琰 张霖 刘海峰[1] 彭红芬[1] 张东友[1] BAI Yuhan;YANG Jian;SONG Zhiyan;ZHANG Lin;LIU Haifeng;PENG Hongfen;ZHANG Dongyou(Department of Radiology,Wuhan No.1 Hospital,Wuhan 430022,China;Department of Gastroenterology,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院放射科,湖北武汉430022 [2]武汉市第一医院消化内科,湖北武汉430022

出　　处：《实用放射学杂志》2024年第6期913-916,930,共5页Journal of Practical Radiology

基　　金：武汉市卫生健康委员会科研计划项目(WX20D05)。

摘　　要：目的分析乳腺结构扭曲(AD)的乳腺X线摄影、MRI及超声表现,探讨各影像检查诊断AD病变的价值。方法回顾性分析46例(48个病灶)经乳腺X线摄影检出AD患者的乳腺X线摄影、超声及MRI资料,以病理结果为标准,比较良恶性AD的影像特征。结果良恶性形态学、中心密度差异有统计学意义。良恶性AD有无微钙化差异无统计学意义。48个病灶MRI表现肿块样强化26个,非肿块样强化17个,点状强化3个,无强化2个,强化类型分布差异无统计学意义。良恶性AD时间-信号强度曲线(TIC)类型差异有统计学意义。良恶性AD超声表现差异无明显统计学意义。将影像学表现大于乳腺影像报告和数据系统(BI-RADS)4类作为可疑恶性诊断,以病理检查结果为标准,乳腺X线摄影、超声、MRI诊断乳腺良恶性AD的曲线下面积(AUC)分别为0.582、0.426、0.764,三者的诊断效能具有显著性差异。结论MRI检出乳腺AD敏感度和特异度较高,明显提高了病变的诊断符合率,能为临床医师手术治疗方案的决策提供重要依据。Objective To analyze the characteristics of breast architectural distortion(AD)in mammography,MRI,and ultrasound,and to explore the value of each imaging examination in the diagnosis of AD lesions.Methods The mammography,ultrasound,and MRI data of 46 patients(48 lesions)with AD detected by mammography were analyzed retrospectively.Based on the pathological results,the imaging characteristics of benign and malignant AD were compared.Results The morphological and central density differences between benign and malignant lesions were statistically significant.There was no significant difference in microcalcification between benign and malignant AD.On 48 breast MRI,26 lesions showed mass enhancement,17 lesions showed non-mass enhancement,3 lesions showed punctate enhancement and 2 lesions showed no enhancement.There was no statistical significance in the distribution of enhancement types.The difference in time-signal intensity curve(TIC)types between benign and malignant AD was statistically significant.There was no statistical significance in ultrasound manifestation between benign and malignant AD.Using imaging findings greater than those in the breast imaging reporting and data system(BI-RADS)4 categories as a suspected malignant diagnosis,based on pathological examination results.The area under the curve(AUC)by mammography,ultrasound,and MRI was 0.582,0.426,and 0.764,respectively,showed significant differences in diagnostic efficiency.Conclusion MRI has higher sensitivity and specificity in detecting breast AD,which significantly improves the diagnosis coincidence rate of lesions,and can provide an important basis for clinicians to make decisions on surgical treatment.

关 键 词：乳腺 结构扭曲 乳腺X线摄影 磁共振成像 超声 

分 类 号：R655.8[医药卫生—外科学] R814.41[医药卫生—临床医学] R445.2R445.1