MRI与彩色多普勒超声对乳腺癌的诊断价值

Diagnostic Value of Doppler Ultrasound and Magnetic Resonance Imaging in Breast Cancer

目的探讨彩色多普勒超声(US)与磁共振(MRI)对乳腺癌的诊断价值。方法对71例乳腺肿块病人均行US及MRI检查[平扫(TR 9 145ms,TE 75ms,TI 150ms,层厚2.8mm,FOV 320mm×320mm,矩阵256mm×512mm)、动态增强扫描(TR 12mm,TE 4.6mm,层厚1.8mm,翻转角25°,FOV 320mm×320mm,矩阵512mm×512mm)],图像处理后结合血流动力学进行分析。结果 71例病人行US联合MRI检查的乳腺癌正确率明显高于行US和MRI检查(93.0%vs 78.9%、88.7%,P<0.05)。71例病人行MRI检查的特异度明显高于行US检查(88.0%vs 64.0%,P<0.05)、误诊率明显低于行US检查(12.0%vs 36.0%,P<0.05),71例病人行US联合MRI检查的敏感度、特异度、准确率均明显高于US、MRI检查(95.7%、88.0%、93.0%vs 87.0%、64.0%、78.9%、89.1%、88.0%、88.7%,均P<0.05)、误诊率、漏诊率均明显低于行US检查(12.0%、4.3%vs36.0%、13.0%,均P<0.05)。结论 US联合MRI对乳腺癌的诊断具有较高的特异度和准确率,并可早发现、早诊断乳腺癌,对临床治疗方案的选择提供依据。

Objective To explore the diagnostic value of doppler ultrasound and magnetic resonance imaging（MRI） in breast cancer.Methods Seventy-one patients with breast lumps underwent doppler ultrasound and MRI examination.Precontrast MR images were acquired using coronal sequence：TR,9 145 ms;TE,75 ms;TI,150 ms;thickness,2.8 mm;FOV,320 mm×320 mm;matrix,256 mm×512 mm.Dynamic Gd-DTPA-enhanced MR imaging was performed with the following parameters：TR,12 ms;TE,4.6 ms; thickness,1.8 mm;FA,25°;FOV,320 mm×320 mm;matrix,512 mm×512 mm.All images were transferred to a workstation,and data were analyzed in combination with haemodynamics.Results The 71 cases patients accuracy of breast cancer diagnosis by combination of ultrasound and MRI was significantly higher than that by ultrasound or MRI alone（93.0% vs 78.9% or 88.7%,P0.05）.Compared with ultrasound,the specificity of MRI increased significantly（88.0% vs 64.0%,P0.05）,and the misdiagnosis rate decreased obviously（12.0% vs 36.0%,P0.05）.Compared with the combination of ultrasound and MRI,the sensitivity,specificity and accuracy of ultrasound or MRI alone all decreased significantly（87.0%,64.0% and 78.9% or 89.1%,88.0% and 88.7% vs 95.7%,88.0% and 93.0%,respectively;P0.05）,and both misdiagnosis rate and missed diagnosis rate of ultrasound examination increased obviously（36.0% and 13.0% vs 12.0% and 4.3%,respectively;P0.05）.Conclusion The combination of Doppler ultrasound and MRI has high specificity and accuracy in breast cancer.Therefore,it can provide a basis for early diagnosis of breast cancer and choice of clinical treatment.