超声与钼靶联合诊断乳腺导管内癌

Diagnoses of breast ductal carcinoma in situ by combination of ultrasound and mammography

目的分析乳腺导管内癌(DCIS)的超声及钼靶特征,对二者进行对比分析,并探讨二者联合对诊断DCIS的准确性。方法分析经病理证实的30例DCIS的超声和钼靶特征,并利用BI-RADS第4版分别进行评估。结果超声表现为Ⅰ型结节肿块型9例,Ⅱ型导管扩张填充型15例,Ⅲ型结构紊乱型3例,Ⅳ型囊实性混合回声型1例,V型无占位的单纯钙化点型2例。钼靶表现为钙化者23例,表现为局部密度增高或等密度肿块者11例,表现为结构紊乱者13例,未见明确占位病变1例。超声对乳腺导管内癌的诊断符合率为66.6%,钼靶对乳腺导管内癌的诊断符合率80.0%,二者差异无统计学意义(χ2=0.900<χ02.05,1,P>0.05),二者联合对乳腺导管内癌的诊断符合率为90.0%,准确率高于单独使用钼靶和超声检查,差异具有统计学意义(χ2=5.142>χ02.05,1,P<0.05)。结论超声和钼靶对乳腺导管内癌的诊断均有重要价值,二者联合可明显提高对乳腺导管内癌的诊断符合率。

Objective To analyze the features of ductal carcinoma in situ （DCIS） by ultrasound and mammography and estimate the accuracy of ultrasound, mammography and combination of both methods in diagnosis of DCIS. Methods To analyze the mammographic and sonographic images of breast DCIS in 35 patients confirmed by pathology and assessed by BI-RADS （4th）. Results The solid lesion in 9 cases, and ductal ectasia filled with stuff cases in 15 cases, and architecture disorder cases in 3 cases, and mass contains both anechoic and echogenic components in 1 case, and calcification only in 2 cases were observed by ultrasound. By mammography, calcifications were found in 23 cases, nodular lesion or local increased density in 11 cases, architecture disorder cases in 13 cases, and no lesion in 1 case. The coincidence rates of ultrasound and mammography Of DCIS were 66.6% and 80.0%, respectively. ~The accuracy of ultrasound and mammography was not statistically different（x2 = 0.900 〈 x^0.05,1, P 〉 0.05 ） and the coincidence rate of combination of both methods was 90.0%, higher than that of ultrasound （ X2 = 5. 142 〉 x^0.05,1, P 〈 0. 05 ）. Conclusions High-frequency ultrasound and mammography are important in diagnosis of DCIS. The diagnostic accuracy can be improved by combination of ultrasound and mammography.