CE-MRI联合钼靶X线在乳腺良恶性病变鉴别诊断中的应用

Application of CE-MRI combined with mammography in the differential diagnosis of benign and malignant breast lesions

目的探讨磁共振动态增强扫描(CE-MRI)联合钼靶X线乳腺良恶性病变鉴别诊断的应用价值。方法选取本院2015年6月至2018年6月收治的92例乳腺病变患者,患者均有钼靶X线、CE-MRI影像学资料,经病理检查确诊,分析乳腺良恶性病变钼靶X线、CE-MRI影像学特征,比较不同影像学诊断准确度、敏感度、特异度。结果钼靶X线检查结果显示,良性病变病灶大小<1cm、形态规则、边缘清晰、钙化数<10、钙化密度呈高密度比例显著高于恶性病变组(P<0.05);CE-MRI扫描结果显示,良性病变者病灶形态以类圆形为主,边缘形态以光滑为主,均显著多于恶性病变组(P<0.05),而病灶分叶形、边缘毛刺情况显著低于恶性病变组(P<0.05);良性病变时间-信号曲线I型显著低于恶性病变组,III型显著高于恶性病变组(P<0.05),良性病变早期增强率<60%显著高于恶性病变组(P<0.05);钼靶X线+CE-MRI准确度、敏感度、特异度分别为96.74%、94.87%、98.11%,显著高于单独钼靶X线检查的69.57%、61.54%、75.47%(P<0.05)及单独CE-MRI检查的82.61%、79.49%、84.91%(P<0.05)。结论 CE-MRI联合钼靶X线能提高乳腺良恶性病变诊断率,具有较好的临床应用价值。

Objective To explore the application value of dynamic contrast-enhanced magnetic resonance imaging(CE-MRI)combined with mammography in the differential diagnosis of benign and malignant breast lesions.Methods A total of 92 patients with breast lesions admitted to our hospital from June 2015 to June 2018 were selected.All patients had mammography and CE-MRI imaging data,and they were confirmed by pathological examination,and the imaging features of benign and malignant breast lesions were analyzed.The accuracy,sensitivity and specificity of different imaging diagnosis were compared.Results Mammography examination showed that the proportions of lesion size that was under 1 cm,regular shape,clear margin,calcification number under 10 and high density calcification of benign lesions were significantly higher than those of malignant lesions(P<0.05).CE-MRI scan results showed the morphology of lesions was mainly round-like and the margin was mainly smooth in benign lesions,which were significantly more than those of malignant lesions(P<0.05).And the lobulation of lesions and burrs of margin were significantly lower than those of malignant lesions(P<0.05).The time-signal curve of Type I of benign lesions was significantly lower than that of malignant lesions,and the type III was significantly higher than that of malignant lesions(P<0.05),and the benign lesions with early enhancement rate which was under 60% were significantly higher than malignant lesions(P<0.05).The accuracy,sensitivity and specificity of mammography combined with CE-MRI were 96.74%,94.87% and 98.11%respectively,which were significantly higher than those of single mammography with 69.57%,61.54% and 75.47%(P<0.05)and those of single CE-MRI with82.61%,79.49% and 84.91%(P<0.05).Conclusion CE-MRI combined with mammography can improve the diagnosis rate of benign and malignant breast lesions,and has good clinical application value.