钼靶结合MRI对乳腺导管原位癌诊断价值的探讨

Diagnostic value of combined mammography and magnetic resonance imaging in assessment of breast ductal carcinoma in situ

目的:分析乳腺导管原位癌的X线及MRI表现,评价钼靶结合MRI对DCIS术前诊断价值。方法:回顾性分析经手术病理证实的乳腺DCIS病例13例,所有病例均于术前行动态增强MRI和钼靶X线检查,同时行免疫组化标记。结果:①将病灶的X线表现分成恶性钙化、中间性钙化和非钙化3组,PR与C-erbB-2在3组中的分布有统计性意义(P<0.05);②13例病灶中11例MR表现为非肿块样强化,以BI-RADS分级中的4、5级为MR和X线检查的阳性指标,其正确诊断率差异无统计学意义(P>0.05)。结论:DCIS的钼靶X线表现可以作为乳腺DCIS的预后因子,乳腺MRI对导管原位癌及导管原位癌伴微浸润有特征性表现,钼靶X线和MR检查相结合能提高早期导管原位癌的检出率及正确诊断率。

Objective:To retrospectively evaluate the mammographic and magnetic resonance imaging(MRI) features of breast ductal carcinoma in situ(DCIS) and to access diagnostic accuracy of MRI combined with mammography in preoperative assessment of DCIS.Methods:Results of MRI and mammography from 13 women with known breast DCIS were analyzed,and then compared with pathologic examination.The prognostic biologic factors including progesterone receptor(PR),C-erbB-2 were evaluated in 13 cases.Results:① For expression profile of the biological factors,significant differences were found among malignant calcification group,intermediate concern calcification group,and non-calcification group(P<0.05);② 11 lesions showed non-mass-like enhancement on dynamic breast MRI.Regarding the BI-RADS IV or V as the positive standard,the difference was not significant(P>0.05).Conclusion:Mammographic findings could be a prognostic marker.The MR imaging features of DCIS were characteristic.Combined with mammography,MRI increases the diagnoses of DCIS and diagnostic accuracy.