摘要
目的比较全数字化乳腺摄影(full-field digital mammography,FFDM)、磁共振(MRI)增强扫描对乳腺导管癌的诊断价值。方法回顾性分析经手术病理证实的30例乳腺导管癌,所有病例均行FFDM、MRI增强检查。观察X线特征,根据美国放射学会乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS)进行分级,3级及以下的级别考虑为良性,4A级及以上的为恶性;MRI根据病灶增强表现,绘制时间-信号强度曲线诊断病灶的良、恶性。影像诊断与病理结果对照,比较二者对导管癌的检出情况及诊断准确率。结果 30例乳腺导管癌中,FFDM检出13例肿瘤呈单纯结节或肿块,肿块伴有的钙化12例,5例病灶表现为单纯簇状钙化,同侧腋下淋巴结肿大7例。FFDM诊断4A以上病例26例,3级及以下的病例4例;MRI增强扫描检出肿块或结节27例,发现钙化5例,同侧腋下淋巴结肿大10例。时间-信号强度曲线8例呈Ⅱ型曲线,22例呈Ⅲ型曲线。FFDM正确诊断乳腺导管癌24例,MRI增强扫描正确诊断为26例,二者结合正确诊断27例。FFDM、增强MRI及FFDM+增强MRI对导管癌的诊断符合率分别为80%、86.7%、90%。结论 FFDM操作简单,对导管癌的簇状钙化检出率高于增强MRI,诊断敏感性较高,是筛查乳腺导管癌,尤其导管原位癌的首选,增强MRI对乳腺导管癌肿块及同侧腋下淋巴结检出情况高于FFDM,在乳腺导管癌定性方面有重要作用,是乳腺导管癌进行术前评价的有效方法。二者结合应用可以提高乳腺导管癌的诊断正确率。
Objective To compare the value of full-field digital mammography （FFDM） and contrast-enhanced magnetic resonance imaging on diagnosis of ductal carcinoma. Methods A retrospective study of 30 ductal carcinoma patients con- firmed by pathology were conducted, all cases were examined by FFDM and enhanced MRI. The classification was based on the morphology of enhanced lesions according to the breast imaging reporting and data system （BI-RADS） lexicon of the american college of radiology （ACR）. The examination results were subdivided into suspicious benign enhanced lesions （BI-RADS 2 or 3）, or suspicious malignant enhanced lesions （BI-RADS 4 or 5）. The benign and malignant lesions with time-signal intensity curve of contrast-enhanced MRI scanning distinguished, in order to analyze the accuracy rate of detec- tion and diagnosis on ductal carcinoma compared with the imaging diagnosis and pathological results. Results In 30 breast ductal carcinoma, 13 patients presented with simple nodule or mass detected by FFDM, mass with calcification in 12 pa- tients, simple siclustered calcification in 5 patients and ipsilateral axillary lympbadenopathy in 7 patients. BI-RADS was 4A for 26 cases, ≤ 3A for 3 cases by FFDM diagnosis. 27 patients with simple nodule or mass were detected by contrast- enhanced breast MRI, mass with calcification in 5 patients, and ipsilateral axillary lymphadenopathy in 10 patients. There were 8 cases for type II of time- signal intensity curve and 22 cases were type III. The right diagnosis on ductal carcinoma for FFDM, contrast-enhanced Breast MRI and FFDM combined with MRI were 24, 26 and 27 respectively, the right diag- nosis rate was 80%, 86.7%, 90% respectively. Conclusion The advantages for FFDM is simple operation, the detection rate for clustered calcification ductal carcinoma used FFDM is higher than contrast-enhanced MRI. There are higher sensi- tivity rates for FFDM to screening for duetal carcinoma, especially in ductal carcinoma in situ. However, the detection rate for breast cancer mass and ipsilateral axillary lymph node used contrast-enhanced MRI is higher than FFDM. There are important role for the duetal carcinoma qualitative diagnosis and preoperative evaluation. The combination of the two appli cations can improve the correct diagnosis rate for ductal carcinoma.
出处
《医学影像学杂志》
2012年第9期1465-1469,共5页
Journal of Medical Imaging
关键词
乳腺导管癌
全数字化乳腺钼靶
磁共振成像
Ductal earcinoma
Full-field digital mammography
Magnetic resonance imaging
