乳腺癌DCE-MRI与超声、钼靶X线的对比研究及诊断价值分析  

Comparative Study and Diagnostic Value of DCE-MRI,Ultrasound and Molybdenum Target X-ray in Breast Cancer

作　　者：马国津 李佳晶 崔金利[1] MA Guojin;LI Jiajing;CUI Jinli(Department of Medical Imaging,Affiliated Hospital of Changchun University of Traditional Chinese Medicine,Changchun 130021,Jilin,P.R.China;Medical Imaging Department,Jilin Maternal and Child Health Hospital,Changchun 130021,Jilin,P.R.China)

机构地区：[1]长春中医药大学附属医院医学影像科,吉林长春130021 [2]吉林省妇幼保健院医学影像科,吉林长春130021

出　　处：《影像科学与光化学》2024年第6期669-676,共8页Imaging Science and Photochemistry

摘　　要：目的:对比动态增强磁共振成像(DCE-MRI)与超声、钼靶X线的乳腺癌影像学特征,并分析临床诊断价值。方法:回顾性分析2021年10月至2023年9月我院收治的266例乳腺肿瘤患者。所有患者均进行超声和钼靶X线检查,47例患者接受DCE-MRI检查。经手术病理证实乳腺良性肿瘤149例和乳腺癌117例。比较各种影像学检查与病理诊断的一致性、乳腺癌肿块大小与实际的差异以及病变特征。结果:DCE-MRI诊断乳腺癌的灵敏度为100.00%,特异度为85.71%,与病理诊断几乎完全一致(Kappa=0.911)。超声诊断乳腺癌的灵敏度为76.92%,特异度为75.17%,与病理诊断的一致性中等(Kappa=0.516)。钼靶X线诊断乳腺癌的灵敏度为80.34%,特异度为89.26%,与病理诊断高度一致(Kappa=0.701)。超声联合钼靶X线诊断乳腺癌的灵敏度为95.73%,特异度为90.60%,与病理诊断几乎完全一致(Kappa=0.856)。DCE-MRI检查下的肿块直径与实际肿块直径比较无显著性差异(P>0.05)。超声检查下的肿块直径小于实际肿块直径,且小于钼靶X线以及DCE-MRI(P<0.05)。钼靶X线检查下的肿块直径小于实际肿块直径(P<0.05)。对乳腺肿块、肿块毛刺征的检出率比较:超声的检出率最低(P<0.05),钼靶X线的检出率低于DCE-MRI(P<0.05)。对肿块钙化的检出率比较:DCE-MRI的检出率最低(P<0.05),超声的检出率低于钼靶X线(P<0.05)。乳腺癌患者DCE-MRI的容量转移常数(Ktrans)、血管外细胞外间隙容积比(Ve)均高于乳腺良性肿瘤(P<0.05);Ktrans值与Ve值鉴别诊断的灵敏度分别为80.00%与77.50%,特异度均为100%。结论:DCE-MRI评估乳腺癌肿块大小及毛刺征较为准确,灵敏度高。超声联合钼靶X线鉴别诊断乳腺良恶性肿瘤能提高灵敏度和特异度,在对乳腺肿块大小及病变特征的评估上,超声和钼靶X线易低估肿块大小,钼靶X线对微小钙化灶的检出率高。Objective:To compare the imaging characteristics of dynamic contrast enhanced-magnetic resonance imaging(DCE-MRI),ultrasound and molybdenum target X-ray in breast cancer,and analyze the clinical diagnostic value.Methods:A retrospective study was conducted.266 patients with breast tumors treated between October 2021 and September 2023 were enrolled in the study.All patients completed ultrasound and molybdenum X-ray examinations,and 47 patients completed DCE-MRI examinations.149 cases with benign breast tumors and 117 cases with breast cancer were confirmed by surgical pathology.The consistency of each imaging examination and pathological diagnosis,the difference between breast cancer mass size and actual size and characteristics of the lesions were analyzed.Results:The sensitivity and specificity of DCE-MRI in the diagnosis of breast cancer were 100.00%and 85.71%,which was almost consistent with the pathological diagnosis(Kappa=0.911).The sensitivity and specificity of ultrasound in the diagnosis of breast cancer were 76.92%and 75.17%,with moderate consistency with pathological diagnosis(Kappa=0.516).The sensitivity and specificity of molybdenum target X-ray in the diagnosis of breast cancer were 80.34%and 89.26%,which was highly consistent with the pathological diagnosis(Kappa=0.701).The sensitivity and specificity of ultrasound combined with molybdenum target X-ray in the diagnosis of breast cancer were 95.73%and 90.60%,which was almost consistent with pathological diagnosis(Kappa=0.856).There was no significant difference between the tumor diameter measured by DCE-MRI and the actual tumor diameter(P>0.05).The mass diameter measured by ultrasound examination was smaller than the actual mass diameter and that measured by molybdenum target X-ray and DCE-MRI(P<0.05).The mass diameter measured by molybdenum target X-ray was smaller than the actual mass diameter(P<0.05).For detection of breast masses and spiculation,the detection rate of ultrasound was the lowest(P<0.05),and the detection rate of molybdenum target X-

关 键 词：乳腺肿瘤 乳腺癌 超声 钼靶X线 动态增强磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤]