论著-头颈部
超声、MRI及其联合在乳腺癌患者诊断效能比较
作者:秦巧娜1 郑 剑2
所属单位:1.河南省鹤壁市中医院功能科 (河南 鹤壁 458030) 2.河南省鹤壁市中医院影像科 (河南 鹤壁 458030)
PDF摘要
目的 分析和比较超声、MRI及 其联合在乳腺癌中的诊断效能。方法 选 取我院2012年9月至2016年12月期间收治 的80例乳腺癌患者为研究对象,均行多 普勒超声检查、MRI平扫和增强扫描,以 病理确诊为依据,比较超声、MRI及其 超声联合MRI三种方式诊断准确率,并分 析乳腺癌的超声、MRI特征。结果 80例 乳腺癌患者病理确诊为浸润性导管癌53 例、浸润性小叶癌13例、导管内癌5例、 黏液腺癌5例、髓样癌4例,超声与MRI联 合诊断准确率97.50%显著高于超声诊断 准确率85.00%和MRI诊断准确率87.50%(P <0.05),超声、MRI诊断准确率比较无 较无统计学意义(P>0.05)。超声特征为 病灶直径多>1cm,肿块形态不规则,边 缘模糊,见毛刺,回声低而不均匀,有 砂粒样钙化,腋窝淋巴结紊乱,血流信 号Ⅱ级-Ⅲ级,血流丰富。MRI特征为乳 腺组织分界不清,边缘不规则,见分叶 状、毛刺征及点状钙化,平扫T1WI呈较 低信号,T2WI高信号或稍高信号,内部 信号不均匀,增强扫描不均匀或分隔强 化。结论 超声、MRI均可较好的显示乳 腺癌的内部结构和特征,二者各有优缺 点,联合应用诊断乳腺癌准确率高,具 有较高的应用价值。
Objective To analyze and compare the efficacy of ultrasound, MRI and their combination in the diagnosis of breast cancer. Methods Eighty patients with breast cancer who were admitted to our hospital between September 2012 and December 2016 were selected as study subjects. All patients underwent Doppler ultrasonography, MRI scan and enhanced scan. With the pathological diagnosis as the basis, the diagnostic accuracy rates of ultrasonography, MRI and ultrasound combined with MRI were compared, and the ultrasonic and MRI findings of breast cancer were analyzed. Results Among 80 cases with breast cancer, there were 53 cases with pathologically confirmed invasive ductal carcinoma, 13 cases with invasive lobular carcinoma, 5 cases with intraductal carcinoma, 5 cases with mucinous adenocarcinoma and 4 cases with medullary carcinoma. The diagnostic accuracy rate of ultrasound combined with MRI (97.50%) was significantly higher than that of ultrasound diagnosis (85.00%) and MRI (87.50%) (P<0.05), and the diagnostic accuracy showed no statistically significant difference between ultrasound and MRI (P>0.05). The ultrasonic findings included diameter of lesions>1cm, irregular shape of masses, blurred edges, spiculation, low and unevenecho, grit calcification, axillary lymph node disorders, grade II-IIIblood flow signals and rich blood flow. MRI findings included boundaries of breast tissues, irregular edges, lobulated, spiculation and punctate calcification. Plain T1WI showed low signal, T2WI showed high signal or slightly high signal, and the internal signal was inhomogeneous. Enhanced scan showed inhomogeneous or separated enhancement. Conclusion Both ultrasound and MRI can better display the internal structures and characteristics of breast cancer. They have their own advantages and disadvantages, and the accuracy of combined diagnosis of breast cancer is high, with high application value.
【关键词】超声;MRI;乳腺癌;诊断
【中图分类号】R737.9
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2017.06.022
前言
乳腺癌的发病率不断上升,我国部分城市乳腺癌的发病率甚至超 过宫颈癌成为发病率最高的女性恶性肿瘤(发病率可高达10%),已引 起临床学者及广大女性的普遍重视。乳腺癌常好发于40岁以上女性, 其预后不良、致死率高,尤其是乳腺癌早期症状无特异性,大部分患 者临床确诊时已处于中晚期状态,失去最佳手术机会,严重威胁广大 女性患者的身体健康与生命安全[1]。因此,早期诊断出乳腺癌对手术 及放化疗方案制定、改善预后具有十分重要的意义。临床上常见的诊 断与鉴别乳腺癌的途径主要有常规二阶超声、高频彩色多普勒超声、 MRI、CT等影像学方式及血清糖类抗原(CA125)等生化指标检测,其各 有优缺点[2]。本文以我院近期收治的80例乳腺癌患者为研究对象,探 讨超声、MRI及其联合在乳腺癌中的临床诊断价值。现报告如下。
中国CT和MRI杂志
第15卷, 第 6 期
2017年06月
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