乳腺X线摄影、超声及磁共振诊断乳腺癌的性能评价

Performance evaluation of breast cancer diagnosed with mammography, ultrasound and MRI

目的:探讨乳腺X线摄影、超声及MRI诊断乳腺癌的临床价值。方法:选取我院2011年7月-2017年6月乳腺病变患者129例,年龄26~75岁,平均(45.0±8.2)岁。所有患者均在1月内接受过乳腺X线摄影、超声及MRI检查,并对其诊断结果进行分析,比较阳性预测值(PPV)、阴性预测值(NPV)、准确性、灵敏度、特异度、ROC曲线及ROC曲线下面积(AUC)。结果:乳腺X线摄影、超声诊断乳腺癌的PPV和NPV均低于MRI (89.5%和98.1%)。MRI诊断乳腺癌的准确性(93.0%)、灵敏度(98.6%)、AUC(0.938)显著高于乳腺X线摄影的准确性(72.9%)、灵敏度(85.5%)、AUC(0.806)和超声的准确性(73.6%)、灵敏度(71.0%)、AUC(0.814)(P<0.000 1)。结论:MRI诊断乳腺癌的准确性、灵敏度、AUC均高于乳腺X线摄影及超声,MRI在诊断及鉴别乳腺良恶性肿瘤方面具有较高的临床价值,值得广泛应用。

Objective: To explore and compare the clinical value of mammography, ultrasound and MRI in the diagnostic accuracy of breast cancer. Methods: One hundred and twenty-nine suspected breast cancer patients(26 to 75 years old) from July 2011 to June 2017 in our hospital were selected. All patients underwent mammography, ultrasound and MRI within one month. The positive predict value(PPV), negative predict value(NPV), accuracy, sensitivity, specificity of double imaging modalities were analyzed and compared by constructing a summary of receiver-operating characteristic(ROC) curves, area under the ROC curve(AUC). Results: The PPV and NPV of mammography and ultrasound in breast cancer was lower than that of MRI(89.5%, 98.1%). The accuracy(93.0%), sensitivity(98.6%) and AUC(0.938) of MRI in the diagnosis of breast cancer were significantly higher than the accuracy(72.9%), sensitivity(85.5%), AUC(0.806) of mammography, and accuracy(73.6%), sensitivity(71.0%) and AUC(0.814) of ultrasound(P<0.000 1). Conclusion: The accuracy, sensitivity, and AUC of MRI in the diagnosis of breast lesions are higher than mammography and ultrasound. And the performance of MRI is better in distinguishing malignant from benign breast carcinoma.