动态增强磁共振扫描与超声弹性成像对乳腺癌的诊断价值探讨

Research on the Values of the DCE-MRI and the UE on the Diagnosis of Breast Cancer

目的:探讨动态增强磁共振成像扫描与超声弹性成像对乳腺癌良恶性肿瘤的诊断价值,为临床诊断提供影像学依据。方法:回顾性分析2009年10月至2013年5月在我院经穿刺或手术病理证实为乳腺癌的59例患者的临床资料,患者术前均行超声与动态增强MR检查。依据病理组织活检和临床随访分别评价动态增强MR和UE对乳腺癌诊断的准确性。结果:DCE-MRI检测共发现病灶59个,55个初步诊断乳腺恶性肿瘤(BI-RADS 4-5),4个诊断为良性(BI-RADS 3),诊断准确率为93.22%(55/59)。UE对59个病灶进行评分,54个评分为乳腺恶性肿瘤,5个评分为良性,诊断率为91.53%(54/59)。UE检测乳腺癌的敏感性明显低于DCE-MRI及DCE-MRI+UE,DCE-MRI检测乳腺癌的特异性明显低于UE及DCE-MRI+UE,差异具有统计学意义(P<0.05)。DCE-MRI+UE诊断乳腺癌的准确率为96.61%(57/59),明显高于DCE-MRI或UE单独检测的准确率(P<0.05)。结论:动态增强MR诊断乳腺癌的敏感性较高,而超声弹性成像的特异性较好,两者联合可提高诊断准确率,对乳腺癌的早期诊断具有重要的临床应用价值。

Objective： To study the values of the dynamic enhanced magnetic resonance imaging scans and the ultrasound elasticity on the diagnosis of the breast tumors in order to provide the basic imaging data for the clinical treatment. Methods： A retrospective analysis of the clinical data of 59 patients with breast cancer who were confirmed by the clinical biopsy or pathology in our hospital between October 2009 and May 2015 was conducted. The patients all had the UE and the DCE-MRI inspection before the operation. According to the pathological biopsy and the clinical follow-ups, the diagnostic accuracy of the UE and DCE-MRI were evaluated and analyzed. Results： The diagnostic accuracy of the DCE-MRI was 93.22%（55/59）, That is, among the 59 leisions discovered, 55 of them were the malignant tumor（BI-RADS4-5） and another 4 were the benign ones（BI-RADS3）; The diagnostic accuracy of the UE was 91.53%（54/59）, which means there were 54 cases of malignant tumor（4 scores）, and 5 benign one. The sensitivity of the UE was significantly lower than those of the DCE-MRI and DCE-MRI＋UE, the specificity of DCE-MRI was significantly lower than those of the UE and DCE-MRI＋UE（P〈0.05）. The diagnostic accuracy of DCE-MRI＋UE was 96.61%（57/59） which was significantly higher than those of the DCE-MRI or UE（P〈0.05）. Conclusion： The sensitivity of the DCE-MRI on the diagnosis of breast cancer was high, while the specificity of ultrasound elasticity on the diagnosis of breast cancer was better. It is suggested that the combination of the DCE-MRI and the UE could improve the diagnostic accuracy of breast cancer.