DCE-MRI诊断乳腺X线摄影中检出的BI-RADS 3类和4A类微钙化的准确性  

Accuracy of DCE-MRI in the diagnosing of BI-RADS 3 and 4A microcalcifications detected in X-ray mammography

作　　者：滕慧 郭兴 何志娟 TENG Hui;GUO Xing;HE Zhijuan(Medical Imaging Department,Liuzhou Worker's Hospital,Liuzhou 545005,China)

机构地区：[1]柳州市工人医院医学影像科,广西柳州545005

出　　处：《临床医学研究与实践》2025年第9期102-105,共4页Clinical Research and Practice

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(No.Z-B20221424)。

摘　　要：目的探讨动态增强磁共振成像(DCE-MRI)诊断乳腺X线摄影中检出的乳腺影像报告和数据系统(BI-RADS)3类和4A类微钙化的准确性。方法选取2020年1月至2023年12月在柳州市工人医院就诊的40例BI-RADS 3类和4A类单侧乳腺微钙化的女性患者作为研究对象。所有患者均进行乳腺X线钼靶检查及DCE-MRI检查。以病理诊断结果(穿刺活检)作为金标准,比较X线钼靶检查、DCE-MRI检查对乳腺钙化病灶定性诊断的效能,以及两种影像检查方法与病理诊断结果之间的一致性情况。结果40例BI-RADS 3类和4A类乳腺微钙化病变的X线钙化以不定形形态(72.50%)、集群样分布(65.00%)多见;DCE-MRI强化方式以非肿块样强化(47.50%),动态增强Ⅱ型曲线(52.50%)为主。经DCE-MRI检查,40例乳腺微钙化病变中有7例降级为1-2类,8例升级为4B-5类。DCE-MRI检查诊断乳腺癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于X线钼靶检查,差异具有统计学意义(P<0.05)。X线钼靶检查与病理诊断结果的Kappa值为0.340,呈低度一致性;DCE-MRI检查与病理诊断结果的Kappa值为0.898,达到高度一致性。结论针对BI-RADS 3类和4A类乳腺微钙化病变进行定性诊断时,相比于乳腺X线钼靶检查,DCE-MRI检查的诊断效能更为准确。Objective To investigate the accuracy of dynamic contrast enhanced-MRI(DCE-MRI)in the diagnosis of Breast Imaging Reporting and Data System(BI-RADS)3 and 4A microcalcifications detected in X-ray mammography.Methods Forty female patients with BI-RADS 3 and 4A unilateral breast microcalcification who were treated in Liuzhou Worker's Hospital from January 2020 to December 2023 were selected as the study objects.All patients underwent X-ray mammography and DCE-MRI examination.The pathological diagnosis results(puncture biopsy)were used as the gold standard to compare the efficacy of X-ray mammography and DCE-MRI in the qualitative diagnosis of breast calcification lesions,and the consistency between the two imaging methods and pathological diagnosis results.Results The X-ray calcification of 40 cases of BI-RADS 3 and 4A breast microcalcifications were more common in amorphous form(72.50%)and cluster-like distribution(65.00%),and the DCE-MRI enhancement method was mainly non-mass-like enhancement(47.50%)and dynamic enhancement typeⅡcurve(52.50%).After DCE-MRI examination,7 of the 40 cases of breast microcalcifications were downgraded to 1-2 categories,and 8 cases were upgraded to 4B-5 categories.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of DCE-MRI in the diagnosis of breast cancer were higher than those of X-ray mammography,and the differences were statistically significant(P<0.05).The Kappa value of X-ray mammography and pathological diagnosis was 0.340,showing low consistency.The Kappa value of DCE-MRI examination and pathological diagnosis was 0.898,which reached a high degree of consistency.Conclusion Compared with X-ray mammography,DCE-MRI is more accurate in the qualitative diagnosis of BI-RADS 3 and 4A breast microcalcifications.

关 键 词：乳腺微钙化 乳腺影像学报告和数据系统 乳腺癌 磁共振成像 动态增强扫描 X线钼靶检查 

分 类 号：R737.9[医药卫生—肿瘤]