动态增强MRI与钼靶X线评估乳腺癌患者保乳术的临床价值

Clinical Value of Dynamic Contrastenhanced MRI and Mammography in Breast Conserving Surgery for Breast Cancer Patients

目的探讨动态增强MRI扫描与钼靶X线摄影联合评估乳腺癌患者能否行保乳术的临床价值。方法选择2016年1月至2017年8月在我院行乳腺癌根治手术的患者资料进行回顾性分析,术前同时接受动态增强MRI、钼靶检查,观察动态增强MRI和钼靶X线评估患者能否行保乳术的临床价值。结果钼靶X线和动态增强MRI检测主癌灶个数、长径相比较差异无统计学意义(P>0.05);钼靶X线子灶检出个数、距乳晕距离、乳晕侵犯、砂粒样钙化、胸肌侵犯、淋巴结转移个数与动态增强MRI相比,较均有统计学差异(P<0.05)。动态增强MRI预测保乳术的特异性、敏感度、符合率和AUC均高于钼靶X线;动态增强MRI和钼靶X线阳性预测保乳术的特异性均高于单纯动态增强MRI和钼靶X线;动态增强MRI或钼靶X线之一阳性预测保乳术的敏感度高于单纯动态增强MRI和钼靶X线。结论动态增强MRI与钼靶X线均是评估保乳术重要检查手段,二者各有优缺点,临床可根据实际情况灵活运用。

Objective To investigate the dynamic enhanced MRI scanning and mammography combined assessment of clinical value of breast conserving surgery or breast cancer patients.Methods Data from January 2016 to August 2017 in patients with radical surgery in our hospital for breast cancer were retrospectively analyzed.The preoperative and dynamic contrast-enhanced MRI,mammography,observation the clinical value of dynamic contrast-enhanced breast conserving surgery can MRI and mammography were evaluated.Results Mammography and dynamic enhanced MRI in the detection of the main tumor number,there was no significant difference between long diameter(P >0.05),mammography sub foci number,distance from the areola Areola,invasion,calcification,muscle invasion,lymph node metastasis and the number of dynamic enhanced MRI were statistically significant(P<0.05).Dynamic enhanced MRI predictive specificity,the sensitivity of breast conserving surgery,and the coincidence rate of AUC was higher than that of mammography,dynamic enhanced specificity of breast conserving surgery and MRI molybdenum target X line positive predictive was higher than that of dynamic enhanced MRI and mammography;sensitivity is higher than that of pure molybdenum target X-ray dynamic enhanced MRI and dynamic enhanced MRI or positive predictive mammography in breast conserving surgery.Conclusion Dynamic contrast-enhanced MRI and mammography are evaluation of breast conserving surgery for an important examination method,two Each has its own advantages and disadvantages,and it can be applied flexibly according to the actual situation.