MR增强扫描与钼钯检查对导管原位癌的诊断价值

Diagnosis value of ductal carcinoma in situ with contrast-enhanced MRI and mammography

目的比较MR增强扫描和钼钯对乳腺导管原位癌的诊断价值。方法收集2010～2011年经手术证实为导管原位癌的33位病人(平均年龄60岁,平均病灶大小15 mm)作为研究对象,在术前常规进行MR增强扫描和钼钯检查。结果在经病理证实为导管原位癌33例病人中,MR增强扫描诊断出29例患导管原位癌,其敏感性是87.9%。其中有4例导管原位癌被诊断为良性。而33例病人中钼钯检查诊断21例患导管原位癌(其中包括没有被MR检出的病人),其敏感性是63.6%,其它12例都是由MR增强扫描诊断出。结论钼钯和MR增强扫描都能检出没有钙化的隐匿性导管原位癌,但是MR增强扫描在诊断伴有钙化的小的病灶时需要经钼钯证实。

Objective： To compare mammography with contrast-enhanced MRI in the diagnosis of histopathologically verified subtypes of ductal carcinoma in situ（DCIS）.Methods： All patients with verified pure DCIS lesions（no signs of invasion or microinvasion） after surgery were identified between 2005 and 2007.Selection criteria were performed mammography and contrast-enhanced MRI at our institute prior to surgery resulting in a cohort of 33 patients（mean patient age,60 years;mean lesion size,15 mm）.Results： Contrast-enhanced MRI enabled identification of DCIS in 29 of 33 patients with histopathologically verified pure DCIS,with an overall sensitivity of 87.9% for this patient cohort.The remaining 4 showed no signs of malignancy by contrast-enhanced MRI.In mammography,21 of the 33 patients revealed suspicious outcome（including all lesions not detected by contrast-enhanced MRI）,demonstrating an overall sensitivity of 63.6%.The remaining 12 mammographically occult DCIS lesions were all identified in contrast-enhanced MRI.Conclusion： Contrast-enhanced MRI can diagnose mammographically visible and also occult DCIS lesions without microcalcifications.Only small DCIS foci with microcalcifications can additionally be verified by mammography supposing contrast-enhanced MRI as a diagnostic approach