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MRI增强扫描与钼 靶成像在鉴别乳腺 导管原位癌中应用 研究*

作者:王春光 郝宗爱 闫少华 孙长录

所属单位:河南省新乡市中心医院放射科 (河南 新乡 453000)

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摘要

目的 探讨MRI增强扫描与钼靶 成像在诊断乳腺导管原位癌(DCIS)中应 用价值。方法 回顾性分析42例经临床 病理证实为DCIS患者的钼靶、MRI影像 学资料,分析两种影像学方式单独及联 合诊断准确率。结果 钼靶检查显示, 71.43%患者为BI-RADS 4-5级,典型表现 为特征性密集的钙化病灶。MRI检查显 示,83.33%患者为BI-RADS 4-5级,典 型表现为增强扫描非肿块强化、TIC 曲 线呈Ⅱ-Ⅲ型。以临床病理检查为“金 标准”,钼靶+MRI诊断DCIS的准确率为 92.86%高于钼靶(71.43%)(P<0.05),略 高于MRI(83.33%)(P>0.05)。结论 DCIS 在钼靶、MRI上均存在特征性表现,两者 联合诊断可提高诊断准确率。

Objective To evaluate the application value of magnetic resonance imaging (MRI) enhanced scanning and mammography in the differential diagnosis of breast ductal carcinoma in situ (DCIS). Methods The imaging findings of mammography and MRI of 42 patients with clinically and pathologically confirmed DCIS were analyzed retrospectively. The accuracy rates of alone or combined diagnosis of the two imaging methods were analyzed. Results Mammography showed that 71.43% of the patients were BI-RADS grade 4-5, and the typical manifestation was characteristic dense calcification lesions. MRI examination showed that 83.33% of the patients were BI-RADS grade 4-5, and the typical manifestations were non-tumor enhancement and II-III type TIC. With the clinical and pathological examination as the golden standard, the accuracy of mammography combined with MRI in the diagnosis of DCIS (92.86%) was higher than that of mammography (71.43%) alone (P<0.05) and slightly higher than MRI (83.33%) alone(P>0.05). Conclusion Both of mammography and MRI show characteristic manifestations of DCIS and the combined diagnosis can improve the diagnostic accuracy.

【关键词】乳腺导管原位癌;钼靶;磁 共振成像;诊断

【中图分类号】R445.2;R734.4

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2018.01.028

前言

乳腺导管原位癌(DCIS)是乳腺癌的癌前病变,占新发乳腺癌的 20%~30%[1]。提高对DCIS的检出率是临床早期诊断乳腺癌的关键。钼 靶是临床诊断DCIS较为常用的影像学手段,具有操作简便、经济的特 点,可清楚显示乳腺肿块的形态、边界及钙化情况,但对乳腺小肿瘤 的诊出率较低。MRI具有良好的软组织分辨率,受乳腺致密度的影响较 小,在乳腺癌诊断及鉴别诊断中优势明显[2]。对此,本研究回顾性分 析了42例DCIS的钼靶和MRI影像学资料,分析两者影像学诊断,比较两 者影像学单独及联合诊断DCIS的准确性,探讨两种影像学方式联合诊 断本病的优势,现报道如下。