自动乳腺全容积成像和磁共振成像、钼靶影像学特征在三阴性乳腺癌的诊断及预后分析的价值  

Automated Breast Ultrasound Imaging,Magnetic Resonance Imaging,and Molybdenum Target Imaging Characteristics in the Diagnosis and Prognostic Analysis of Triple-Negative Breast Cancer

作　　者：张琪茹 赵辉 韩华[1] ZHANG Qiru;ZHAO Hui;HAN Hua(Department of Ultrasound,Xinxiang Central Hospital,Xinxiang,Henan Province 453000,P.R.China)

机构地区：[1]河南省新乡市中心医院超声科二,453000

出　　处：《临床放射学杂志》2025年第1期69-75,共7页Journal of Clinical Radiology

基　　金：吴阶平医学基金会临床科研专项资助项目(编号:320.6750.2022-19-65)。

摘　　要：目的探讨自动乳腺全容积成像(ABVS)和MRI、钼靶影像学特征对三阴性乳腺癌(TNBC)的诊断及预后的价值。方法搜集经病理检测与免疫组织化学检测证实为TNBC患者47例和非三阴性乳腺癌(nTNBC)患者43例。均行ABVS、MRI、钼靶检查,比较两组患者的临床资料、ABVS、MRI、钼靶影像学特征、不同检查方式对TNBC的诊断效能及预后不同TNBC患者的影像学特征。结果TNBC组患者年龄>35岁、肿瘤直径>2 cm、病理分期为Ⅲ期、淋巴结转移患者占比显著高于nTNBC组(P<0.05);TNBC与nTNBC患者的ABVS(肿块形态、边缘、钙化类型、后方回声衰减)、MRI(肿块大小、形态、边缘、内部强化、表观扩散系数、峰值强化率、峰值时间值)、钼靶检查(钙化情况)影像学特征差异均有统计学意义(P<0.05);ABVS、MRI联合钼靶检查诊断TNBC的特异度、敏感度、准确率、预测率均显著高于单一或任意两种检查方法(P<0.05);TNBC预后良好、预后不良患者钙化情况、汇聚征、后方回声衰减、内部强化、峰值强化率差异均有统计学意义(P<0.05)。结论ABVS、MRI联合钼靶影像学特征在TNBC诊断及预测预后中的应用价值较高。Objective Exploring the diagnostic and prognostic value of Automated Breast Volume Scanning(ABVS)and the imaging features of magnetic resonance imaging(MRI)and mammography in triple-negative breast cancer(TNBC).Methods A total of 47 cases of TNBC patients and 43 cases of non-TNBC patients confirmed by pathological and immunohistochemical tests were collected.Both groups underwent ABVS,MRI,and molybdenum target examination to compare the clinical data,ABVS,MRI,molybdenum target imaging features,the diagnostic efficiency of different examination methods for TNBC,and the imaging characteristics of TNBC patients with different prognoses.Results Patients with TNBC who are over 35 years old,have tumors larger than 2 cm,are classified as stage III,and have lymph node metastasis have a significantly higher prevalence compared to those in the nTNBC group(P<0.05).There are significant differences in the imaging features between TNBC and nTNBC patients as assessed by ABVS(including mass morphology,margins,calcification type,and posterior echo attenuation),MRI(mass size,morphology,margins,internal enhancement,apparent diffusion coefficient,peak enhancement rate,and peak time),and mammography(calcification status)(P<0.05).The specificity,sensitivity,accuracy,and predictive value of diagnosing TNBC using the combination of ABVS,MRI,and mammography are significantly higher than those obtained using any single method or any two methods(P<0.05).There are significant differences in calcification status,converging signs,posterior echo attenuation,internal enhancement,and Emax between patients with good and poor TNBC prognoses(P<0.05).Conclusion The combined application of ABVS and MRI with mammography imaging characteristics is highly valuable in the diagnosis and prognosis prediction of TNBC.

关 键 词：三阴性乳腺癌 自动乳腺全容积成像 磁共振成像 乳腺钼靶X线 预后 

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