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钼靶、超声联合MRI 检查对早期乳腺癌诊断的价值

作者:罗凤莲1 漆 赤2 何莎莎2 郑 婷2

所属单位:1.四川省泸州市人民医院放射科 (四川 泸州 646000) 2.泸州医学院附属医院放射科 (四川 泸州 646000)

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摘要

目的 探讨钼靶、超声联合MRI 检查在早期乳腺癌患者临床诊断中的应 用价值。方法 收集经手术和病理证实的 46例乳腺癌病例作为研究对象,均行X线 钼靶、彩色多普勒超声、MRI检查,观察 三种检查方法的影像学表现,并比较不同 检查方法对肿块、钙化、肿块内部结构、 微小病灶等方面的敏感性,比较诊断符合 率。结果 三种检查方法对肿块、微小病 灶敏感性的两两差异无统计学意义(P> 0.05);X线钼靶与彩超对钙化敏感性均 高于MRI,彩超与MRI对肿块内部结构的敏 感性均高于X线钼靶,差异有统计学意义 (P<0.05)。X线钼靶、彩超、MRI的诊断 符合率分别为89.1%、82.6%、78.3%,联 合诊断符合率为97.8%。结论 钼靶X线、 彩色多普勒超声、MRI检查方法对早期乳 腺癌的显示各有其优势与不足,诊断准确 性有限,而采取三者的联合检查可最大限 度地避免漏误诊,提高诊断准确率。

Objective To explore the mammography, ultrasonography and MRI examination in the clinical application value of early diagnosis of breast cancer patients. Methods 46 cases with breast cancer confirmed by surgery and pathology as the research object, underwent X-ray mammography, color Doppler ultrasound, MRI examination, to observe the performance of three methods of imaging, and check method to compare different mass, calcification, the internal structure of mass sensitivity of small lesions, compared the diagnostic rate. Results of three methods of the masses, no statistically significant differences in the sensitivity of two two small lesions (P>0.05); mammography and ultrasonography were higher than MRI on calcification of sensitivity, color Doppler ultrasound and MRI were higher than that of X-ray mammography is sensitive to the internal structure of the masses, the difference was statistically significant (P<0.05). X-ray mammography, ultrasound and MRI diagnosis coincidence rate was 89.1%,82.6%,78.3%, the combined diagnosis with rate was 97.8%. Conclusions mammography, color Doppler ultrasound, MRI examination method for early breast cancer showed that each has its advantages and disadvantages, diagnostic accuracy is limited, and take the joint inspection can maximize to avoid misdiagnosis and improve the diagnostic accuracy.

【关键词】乳腺癌;早期;钼靶;超声

【中图分类号】R445.2;R739.9

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.05.021

前言

乳腺癌为对女性最具威胁性疾病,全球范围内发病率均呈升高趋 势,早发现、早诊断与早治疗成为改善预后关键[1]。目前,彩色多普 勒超声、钼靶X线摄片与MRI均为乳腺癌常用检查手段,但易漏,单一 检查有所不足。随着MRI动态增强系统的逐渐完善及反转恢复脂肪抑制 序列临床应用的深入,钼靶、超声联合MRI检查在避免早期乳腺癌患者 漏误诊方面显示出相当优势[2]。本文以经手术和病理证实的46例乳腺 癌患者为例,探析钼靶、超声联合MRI检查诊断乳腺癌的应用价值,现 报道如下。