不同影像学检查对乳腺癌患者术前肿瘤大小准确度的临床研究

A Clinical Study on the Accuracy of Preoperative Tumor Size Evaluation in Patients with Breast Cancer by Different Imaging Examinations

目的:乳腺癌患者术前肿瘤大小判断直接影响手术效果。本研究对X线、超声以及磁共振成像(MRI)三种方法判断乳腺癌患者术前肿瘤大小效果进行对比分析,研究其临床医学价值。方法:对157例乳腺癌患者术前X线、超声以及磁共振检查结果展开回顾性研究,并且以术后得到的实际病灶大小为准确度判断的主要依据对三种方法的检查效果进行比对分析。结果:针对浸润性导管癌,MRI和乳腺X线摄影测量更精确,超声显著低估;针对浸润性导管癌(IDC)+导管癌原位(DCIS), MRI更准确,超声显著低估;针对DICS, X线摄影测量更精确,超声和MRI基本相当;对小叶癌病灶 MRI和X线更精确,超声显著低估。结论:超声与X线非显著的低估病灶大小,组织学肿瘤越大,低估约明显;核磁共振(MRI)非显著性高估,特别是大于2cm的肿瘤。

Purpose: Evaluation of the preoperative tumor size of breast cancer may directly affect the outcome. In this study, mammography, ultrasound and magnetic resonance imaging (MRI) were used in the patients with breast cancer, and accuracy of them in tumor size evaluation before surgery was compared. Methods: A retrospective study was performed on the results of preoperative X-ray, ultrasonography and MRI in 157 patients with breast cancer. The tumor size of the gross pathology obtained after surgery was used as the reference for the accuracy evaluation of the three methods. Results: For invasive ductal carcinomas, MRI and mammography measurements were more accurate, the tumor size was underestimated by ultrasound;for invasive ductal carcinoma (IDC)+ ductal carcinoma in situ (DCIS), MRI was more accurate, the tumor size was underestimated by ultrasound;for DICS, X-ray mammography was more accurate, ultrasound and MRI were basically equivalent;MRI and X-ray were more accurate for lobular carcinoma lesions, and the tumor size was underestimated by ultrasound. Conclusion: Lesion size is underestimated by ultrasound and X-ray, the larger the histological tumor is the more obvious underestimation. Lesion size is overestimated by MRI, especially for those tumors larger than 2 cm in size.