核素闪烁显像与超声结合彩色多谱勒血流显像鉴别乳腺肿块的对照研究

The comparison study of technetium 99m sestamibi scintimammography, ultrasonography and color Doppler flow imaging for breast mass

目的 评价放射性核素乳腺闪烁显像 (SMM)与超声 (US)结合彩色多谱勒血流显像 (CDFI)两种方法对诊断与鉴别诊断乳腺包块良恶性的临床应用 .方法 对 6 7例临床拟诊乳腺肿块的患者分别进行了99Tcm- MIBI(740 MBq)SMM和 US+CDFI乳腺前位及侧位显像 ,并且两种结果分别与病理组织学检查对照 .结果 SMM对 6 7例乳腺肿块诊断的灵敏度、特异性和准确度分别为 92 % ,86 %和 88% ,而US+CDFI分别为 92 % ,81%和 85 % ,二者比较无明显差异 .但对 2 5例病理诊断为乳腺癌患者的腋下淋巴结转移灶的检查结果发现 ,SMM诊断的灵敏度、特异性及准确度分别为71% ,90 %及 80 % ,而 US+CDFI分别为 5 7% ,81%和6 8% .结论 SMM和 U S+CDFI对乳腺癌的诊断有较高的灵敏度和特异性 .SMM对检测乳腺癌患者腋下淋巴结转移灶的灵敏度和特异性较优于

AIM To evaluate the differential diagnosis accu racy of 99 Tc m MIBI scintimammography (SMM) and ultrasonography (US) with color Doppler flow imaging (CDFI) in suspicious primary breast cancers. METHODS 67 patients with breast lesions detected by palpation were selected for the study. All patients received intravenously 740 MBq 99 Tc m MIBI in the arm. Lateral and anterior planar SMM were performed within 15-30 min after the injection. US with CDFI was performed on a separate day. The results of both SMM and US with CDFI were compared with the pathologic diagnoses. RESULTS The overall specificity of the differential diagnosis for breast lesion was 86% by SMM and 81% by US with CDFI. The overall sensitivity of both methods was 92%. The diagnosis accuracy was 88% and 85.1% respectively by SMM and US with CDFI. In detecting the lymph node metastases of 25 patients with breast cancer, the sensitivity of 99 Tc m MIBI imaging and US with CDFI was 74.4% and 57.1% respectively. The specificity was 90.9% and 81.8% respectively by SMM and US with CDFI. CONCLUSION SMM and US with CDFI have high sensitivity and specificity for the noninvasive diagnosis of breast carcinomas. The sensitivity and specificity of SMM for lymph node metastases of breast cancer are higher than those of US with CDFI .