乳腺MRI与乳腺X线在导管原位癌临床诊断中应用的比较研究

Application Comparison of Mammography MRI and Breast X-ray in Clinical Diagnosis for Ductal Carcinoma in Situ

目的:探讨乳腺MRI与乳腺X线检查在导管原位癌(DCIS)诊断中的应用价值。方法:选择2012年5月至2014年9月在我院接受诊治的乳腺DCIS患者52例(58个病灶)为研究对象,对所有患者进行乳腺MRI及X线检查,以病理检查结果作为金标准,比较乳腺MRI及X线检查在导管原位癌(DCIS)诊断中的应用价值。结果:58个病灶中,乳腺MRI共检查出阳性54例,阴性4例,其中误诊或漏诊4例;乳腺X线共检查出阳性49例,阴性9例,其中误诊或漏诊11例。乳腺MRI检查的灵敏度和准确度均显著高于乳腺X线,差异有统计学意义(P<0.05)。此外,乳腺MRI检查的特异度、阳性预测值及阴性预测值均分别高于乳腺X线,但差异无统计学意义(P>0.05)。结论:乳腺MRI检查对DCIS的诊断价值较高,具有广泛的应用前景,但亦存在少数误诊或漏诊。

Objective：To study the application value of mammography MRI and breast X-ray in the diagnosis of ductal carcinoma in situ（DCIS）.Methods：From May 2012 to September 2014 52 patients（58 lesions） with the diagnosis and treatment of breast DCIS patients in our hospital were studied.For all patients with breast MRI and X-ray diagnosis of DCIS,the pathological examination results was as the gold standard,compared breast MRI and X-ray＇s diagnosis value.Results：In the 58 lesions,breast MRI were detected in 54 cases of positive,negative in 4 cases.The true positive in 51 cases,misdiagnosis or missed diagnosis was 4 cases.Breast X-ray detected a total of 49 cases were positive,9 were negative.The true positive in 46 cases,misdiagnosis or missed diagnosis was 11 cases.The sensitivity and accuracy of MRI was significantly higher than that in breast breast X-ray,the difference was statistically significant（P0.05）.In addition,specificity,positive predictive value of breast MRI and negative predictive value were higher than breast x-ray,the difference was statistically significant（P0.05）.Conclusion：The high value of breast MRI in the diagnosis of DCIS,has a wide application prospect,but there are also a handful of misdiagnosis or missed diagnosis.