乳腺数字X射线联合MRI对Bi-RADS 4级可疑恶性微钙化患者的诊断价值  

Diagnostic value of breast digital X-ray combined with MRI in patients with Bi-RADS 4 suspicious malignant microcalcification

作　　者：刘兆丰[1] 金静强[1] 马立岩[1] LIU Zhaofeng;JIN Jingqiang;MA Liyan(Department of Radiology,the Second People’s Hospital of Kunshan City,Jiangsu Province,Suzhou215300,China)

机构地区：[1]江苏省昆山市第二人民医院放射科,江苏昆山215300

出　　处：《中国医药导报》2024年第18期156-158,163,共4页China Medical Herald

基　　金：江苏省基础研究计划(自然科学基金)青年基金项目(BK20210971)。

摘　　要：目的探讨乳腺数字X射线联合磁共振成像(MRI)评估Bi-RADS 4级可疑恶性微钙化的诊断价值。方法选取2021年6月至2023年7月江苏省昆山市第二人民医院行手术治疗的79例乳腺Bi-RADS 4级可疑恶性微钙化患者为研究对象,所有患者均进行乳腺数字X射线、MRI检查。以病理结果为“金标准”,分析良性、恶性患者乳腺数字X射线图像特征、MRI特征,分析不同检查方法的诊断效能。结果以病理检查结果为“金标准”,恶性患者34例,良性患者45例,其中乳腺纤维腺瘤21例、乳腺囊性增生12例、乳腺炎12例。良、恶性患者乳腺微钙化、无定型、粗糙不均质分布比较,差异有统计学意义(P<0.05)。良、恶性患者时间-信号强度曲线各型占比比较,差异有统计学意义(P<0.05)。乳腺数字X射线联合MRI检查的特异度、准确度高于单一检测,差异有统计学意义(P<0.05)。乳腺数字X射线、MRI、乳腺数字X射线联合MRI检查与“金标准”一致性一般,Kappa值分别为0.625、0.630、0.726。结论乳腺数字X射线联合MRI检查诊断Bi-RADS 4级可疑恶性微钙化的价值较高,有助于临床医生准确地判断可疑微钙化患者的恶性可能性。Objective To investigate the diagnostic value of digital X-ray combined with magnetic resonance imaging(MRI)in the evaluation of Bi-RADS 4 suspicious malignant microcalcification.Methods Seventy-nine patients with Bi-RADS 4 suspicious malignant microcalcifications of the breast who underwent surgical treatment at the Second People’s Hospital of Kunshan City,Jiangsu Province,from June 2021 to July 2023 were selected for the study.All the patients underwent digital X-ray and MRI examination of the breast,and the diagnostic efficacy of the different examination methods was analyzed by taking the pathological results as the“gold standard”,and the characteristics of digital X-ray images and MRI features of the breasts of benign and malignant patients was analyzed.Results According to the“gold standard”,there were 34 malignant patients and 45 benign patients,including 21 cases of fibroadenoma,12 cases of cystic hyperplasia,and 12 cases of mastitis.There were significant differences in the distribution of microcalcification in malignant patients,the proportion of amorphous shape,and the proportion of rough uneven shape benign and malignant patients(P<0.05).There were significant differences in the proportion of each type of outflow time-signal intensity curve in malignant patients benign patients(P<0.05).The specificity and accuracy,value of digital X-ray combined with MRI were higher than those of single detection(P<0.05).Digital X-ray,MRI and digital X-ray combined with MRI were generally consistent with the“gold standard”,with Kappa values of 0.625,0.630,and 0.726,respectively.Conclusion Breast digital X-ray combined with MRI is of high value in the diagnosis of Bi-RADS 4 suspicious malignant microcalcification,which is helpful for clinicians to accurately judge the malignant possibility of patients with suspected microcalcification.

关 键 词：乳腺数字X射线 磁共振成像 Bi-RADS 4级 恶性 微钙化 

分 类 号：R445.1[医药卫生—影像医学与核医学]