目的 比较多普勒彩超与磁共振 成像(MRI)联合常规肿瘤标志物检测在乳 腺癌诊断中的应用。方法 回顾性分析研 究对象为2015年3月-2018年5月在我院行 多普勒超声、MRI检查及肿瘤标志物检测 的270例乳腺疾病患者的临床资料，以组 织学病理检查结果为“金标准”，比较 其在诊断乳腺癌中的应用价值。结果 多 普勒彩超、MRI、常规肿瘤标志物检测单 一及任意组合方式诊断乳腺癌的敏感度、 特异度、准确度、阳性预测值、阴性预测 值比较差异均有统计学意义(P＜0.05)； 单一诊断时，MRI灵敏度、准确度、阴 性预测值、kappa值最高，为94.44%、 86.29%、90.00%、0.707，肿瘤标志物检 测诊断的特异度、阳性预测值最佳，为 83.48%、88.60%；两两联合诊断时，多普 勒超声+MRI灵敏度最佳，为94.40%，而 MRI+肿瘤标志物检测诊断的特异度、准确 率、阳性预测值、阴性预测值、kappa值 最佳，分别为91.74%、92.59%、94.33%、 90.09%、0.846；多普勒彩超与MRI联合常 规肿瘤标志物检测时，灵敏度最佳，高达 95.65%，特异度、阳性预测值均低于MRI+ 肿瘤标志物检测诊断，分别为89.90%、 93.33%。结论 多普勒彩超、MRI、常规肿 瘤标志物检测在乳腺癌的临床诊断中均有 一定价值，临床还应结合实际情况联合诊 断，较单一方式诊断或能取得更佳的诊断 效能。

Objective To compare the application of color Doppler ultrasound, magnetic resonance imaging (MRI) and routine detection of tumor markers in diagnosis of breast cancer. Methods The retrospective analysis was performed on the clinical data of 270 patients with breast disease undergoing Doppler ultrasound, MRI examination and routine detection of tumor markers in the hospital from March 2015 to May 2018. Taking histological pathological findings as " the golden standard", the application value in the diagnosis of breast cancer was compared. Results There were significant differences in the sensitivity, specificity, accuracy, positive predictive value and negative predictive value for the diagnosis of breast cancer by any one or any combination of color Doppler ultrasound, MRI and routine detection of tumor markers (P<0.05). In the case of single diagnosis, the sensitivity, accuracy, negative predictive value and kappa value by MRI were the highest (94.44%, 86.29%, 90.00%, 0.707). The specificity and positive predictive value by routine detection of tumor markers were the best (83.48%, 88.60%). In the case of the combination diagnosis with any two of them, the sensitivity by Doppler ultrasound and MRI was the best (94.40%). The specificity, accuracy, positive predictive value, negative predictive value and kappa value were the best by MRI and routine detection of tumor markers (91.74%, 92.59%, 94.33%, 90.09%, and 0.846). The sensitivity was the best (95.65%) by color Doppler ultrasound, MRI and routine detection of tumor markers. And the specificity and positive predictive value were lower than those by MRI and routine detection of tumor markers (89.90% and 93.33%). Conclusion Color Doppler ultrasound, MRI and routine detection of tumor markers are of certain value in clinical diagnosis of breast cancer. The clinical diagnosis should be combined with the actual situation, which can achieve better diagnostic efficiency compared with single diagnosis.