目的 研究多模态磁共振成像 (MRI)联合钼靶X线、超声检查对乳腺良、 恶性病变的鉴别诊断价值。方法 选取我 院2015年6月至2017年6月83例乳腺占位性 病变患者为研究对象，均在我院行病理组 织学检查，于手术或穿刺活检前2周完成 钼靶X线、超声、MRI检查。以手术或穿刺 活检病理结果为金标准，计算钼靶X线、 超声、多模态MRI、多模态MRI联合钼靶X 线、超声鉴别乳腺良、恶性病变的灵敏 度、特异度、阳性预测值、阴性预测值、 总符合率。结果 83例乳腺占位性病变患 者经手术或穿刺活检共发现，乳腺良性 病变60例，乳腺恶性病变23例。钼靶X线 检查的灵敏度、特异度、总符合率分别 为73.9%、76.7%、75.9%，超声检查的灵 敏度、特异度、总符合率分别为82.6%、 83.3%、83.1%，多模态MRI检查的灵敏 度、特异度、总符合率分别为87.0%、 88.3%、88.0%，多模态MRI联合钼靶X线、 超声检查的灵敏度、特异度、总符合率分 别为100.0%、95.0%、95.4%。多模态MRI 联合钼靶X线、超声诊断乳腺良、恶性病 变的灵敏度、特异度、阳性预测值、阴性 预测值、总符合率显著高于钼靶X线检查 (P＜0.05)，特异度、阳性预测值、总符 合率显著高于超声检查(P＜0.05)，总符 合率显著高于多模态MRI检查(P＜0.05)。 结论 钼靶X线、超声与多模态MRI各有优 缺点，通过联合检查可以提高乳腺良、恶 性病变诊断符合率，为乳腺占位性病变诊 断与干预提供影像学依据。

Objective To study the value of multi-modal magnetic resonance imaging (MRI) combined with mammography and ultrasound in the differential diagnosis of benign and malignant breast lesions. Methods 83 patients with breast space occupying lesions who were admitted to our hospital during the period from June 2015 to June 2017 were selected as the subjects. All of them underwent histopathological examination, and the mammography, ultrasound and MRI examinations were performed at 2 weeks before operation or biopsy. The sensitivities, specificities, positive predictive values, negative predictive values and total coincidence rates of mammography, ultrasound, multimodal MRI, multi-modal MRI combined with mammography and ultrasound were calculated with the pathological results of operation or biopsy as the golden standard. Results Operation or biopsy of the 83 patients with breast space occupying lesions found that there were 60 cases with benign breast lesions and 23 cases with malignant breast lesions. The sensitivity, specificity and coincidence rate of mammography were 73.9%, 76.7% and 75.9%, respectively, those of ultrasonography were 82.6%, 83.3% and 83.1%, respectively, those of multi-modal MRI were 87.0%, 88.3% and 88.0%, respectively, and those of multi-modal MRI combined with mammography and ultrasonography were 100.0%, 95.0% and 95.4%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and the total coincidence rate of multi-modal MRI combined with mammography and ultrasonography were significantly higher than those of mammography in the diagnosis of benign and malignant breast lesions(P<0.05). The specificity, positive predictive value and the total coincidence rate of combined examination were significantly higher than those of ultrasound (P<0.05), and the total coincidence rate was significantly higher than that of multi-modal MRI examination (P<0.05). Conclusion Mammography, ultrasound and multi-modal MRI have their own advantages and disadvantages. Combined examination can improve the diagnostic coincidence rateof benign and malignant breast lesions, providing imaging evidences for diagnosis and intervention of breast space occupying lesions.