超声、MRI及其联合在乳腺癌患者诊断效能比较

Comparison of the Efficacy of Ultrasound,MRI and Their Combination in the Diagnosis of Breast Cancer

目的分析和比较超声、MRI及其联合在乳腺癌中的诊断效能。方法选取我院2012年9月至2016年12月期间收治的80例乳腺癌患者为研究对象,均行多普勒超声检查、MRI平扫和增强扫描,以病理确诊为依据,比较超声、MRI及其超声联合MRI三种方式诊断准确率,并分析乳腺癌的超声、MRI特征。结果 80例乳腺癌患者病理确诊为浸润性导管癌53例、浸润性小叶癌13例、导管内癌5例、黏液腺癌5例、髓样癌4例,超声与MRI联合诊断准确率97.50%显著高于超声诊断准确率85.00%和MRI诊断准确率87.50%(P<0.05),超声、MRI诊断准确率比较无较无统计学意义(P>0.05)。超声特征为病灶直径多>1cm,肿块形态不规则,边缘模糊,见毛刺,回声低而不均匀,有砂粒样钙化,腋窝淋巴结紊乱,血流信号Ⅱ级-Ⅲ级,血流丰富。MRI特征为乳腺组织分界不清,边缘不规则,见分叶状、毛刺征及点状钙化,平扫T1WI呈较低信号,T2WI高信号或稍高信号,内部信号不均匀,增强扫描不均匀或分隔强化。结论超声、MRI均可较好的显示乳腺癌的内部结构和特征,二者各有优缺点,联合应用诊断乳腺癌准确率高,具有较高的应用价值。

Objective To analyze and compare the efficacy of ultrasound, MRI and their combination in the diagnosis of breast cancer. Methods Eighty patients with breast cancer who were admitted to our hospital between September 2012 and December 2016 were selected as study subjects. All patients underwent Doppler ultrasonography, MRI scan and enhanced scan. With the pathological diagaaosis as the basis, the diagnostic accuracy rates of ultrasonography, MRI and ultrasound combined with MR.I were compared, and the ultrasonic and MRI findings of breast cancer were analyzed. Results Among 80 cases with breast cancer, there were 53 cases with pathologically confirmed invasive ductal carcinoma, 13 cases with invasive lobular carcinoma, 5 cases with intraductal carcinoma, 5 cases with mucinous adenocarcinoma and 4 cases with medullary carcinoma. The diagnostic accuracy rate of ultrasound combined with MRI（97.51）%） was significantly higher than that of ultrasound diagnosis （85.00%） and MRI（87.50%） （P〈0.05）, and the diagnostic accuracy showed no statistically significant difference between ultrasound and MRI（P〉0.05）. The ultrasonic findings included diameter of lesions〉1cm, irregular shape of masses, blurred edges, spiculation, low and unevenecho, grit calcification, axillary lymph node disorders, grade Ⅱ-Ⅲblood flow signals and rich blood flow. MRI findings included boundaries of breast tissues, irregular edges, lobulated, spiculation and punctate calcification. Plain T1WI showed low signal, T2WI showed high signal or slightly high signal, and the internal signal was inhomogeneous. Enhanced scan showed inhomogeneous or separated enhancement. Conclusion Both ultrasound and MRI can better display the internal structures and characteristics of breast cancer. They have their own advantages and disadvantages, and the accuracy of combined diagnosis of breast cancer is high, with high application value.