钼靶乳腺摄影与高频超声诊断乳腺隐匿性病变的可行性及其互补作用

The feasibility and complementary role of molybdenum target mammography and high-frequent ultrasonography for diagnosing nonpalpable breast lesions

目的探讨钼靶摄片和超声影像对乳腺隐匿性病变的诊断价值以及互补作用。方法收集69例乳腺隐匿性病变的临床资料,所有病例均同时接受了全数字乳腺钼靶摄片和高频超声影像检查,其中至少有一种诊断结果为BI-RADS4～5级,并且均有细针立体定位手术活检病理诊断结果。结果 69例中分别有63例和22例被钼靶和超声诊断为BI-RADS4～5级,而两种诊断均为4～5级的有16例。69例中32例活检病理证实为乳腺癌。63例乳腺钼靶诊断为4～5级病例中有31例病理证实为乳腺癌,而6例诊断为0～3级的病例中仅有1例病理证实为乳腺癌,该病例被超声诊断为5级;超声诊断为4～5级的22例病例有14例为乳腺癌,而另外47例超声诊断为0～3级的病例中有18例病理证实为乳腺癌,两种检查方法对乳腺癌的检出率之间存在显著的统计学差异(χ2=11.19,P=0.004)。结论钼靶摄片对诊断乳腺隐匿性病变是否为癌的可靠性要显著优于超声影像,但是两者联合则能提高其检出率。

Objective To evaluate the feasibility and complementary role of full-digital molybdenum target mammography（DMTM） and high-frequent ultrosonography（HFUS） for diagnosing nonpalpable breast lesions.Methods The clinical data of 69 patients with nonpalpable breast lesions were collected.The breast lesions in all patients were simultaneously diagnosed by DMTM and HFUS,and at least one of imaging diagnosis was corresponding to BI-RADS 4-5 grade.The pathologic diagnosis of breast lesions were performed by needle-localized breast biopsy.Results Sixty-three and twenty-two patients were diagnosed as BI-RADS 4-5 grade by DMTM and HFUS,respectively.Sixteen patients were coincidently diagnosed as BI-RADS 4-5 grade by both techniques.Pathologic diagnosis was proven to breast cancer in 32 patients.There were 31 and 14 breast cancer in patients with BI-RADS 4-5 grade by DMTM（63 pts） and HFUS（22 pts）,respectively.There were 1 and 18 breast cancer in patients with BI-RADS 0-3 grade by DMTM（6 pts） and HFUS（47 pts）（χ2=11.19,P=0.004）.One breast cancer was diagnosed as BI-RADS 1 grade by DMTM,but 5 grade by HFUS.Conclusions DMTM is superior to HFUS in diagnosing malignant tumor from nonpalpable breast lesions,while DMTM combined with HFUS can elevate the detection rate of breast cancer.