3.0T MRI联合X线检查触诊阴性含有钙化灶乳腺癌诊断应用

Clinical application of 3.0T MRI combined with X-ray examination in the diagnosis of breast cancer with palpation-negative calcification

目的:探讨3.0T MRI联合X线检查在触诊阴性含有钙化灶乳腺癌诊断中作用,总结并分析影像特征。方法:分析52例经术前X线定位并术后病理检查,将52例含钙化灶病例随机分为研究组(26例)及对照组(26例),研究组是在做手术定位前做X线及MRI两项检查,对照组是在做手术定位前只做X线检查,没做MRI检查,对比分析两组病例乳腺癌检出率。结果:52例中钙化分布呈线样4例、段样5例、团簇状12例、区域性30例及弥漫性1例;钙化形态呈无定形4例、粗糙不均质15例、细小多形27例及细线分支状6例;研究组病理浸润性导管癌9例、导管内癌3例、派杰氏病1例、囊性增生并囊肿7例、纤维腺病伴纤维腺瘤4例、乳腺炎1例、导管扩张并导管炎1例。对照组病理浸润性导管癌2例、导管内癌2例、叶状肿瘤1例、纤维腺病伴纤维腺瘤4例、囊性增生并囊肿12例、乳腺炎2例、导管扩张并导管炎3例,对比研究两组资料在检查出乳腺癌方面有显著差异性(P≤0.01)。结论:对于可疑形态钙化如在手术X线定位前行MRI检查,在钙化区如发现异常强化灶再行X线定位手术活检将大大提高早期乳腺癌检出率也避免了钙化灶过度活检。本研究表明将X线及MRI两项检查结合起来,比单纯做X线检查在检出乳腺癌方面有显著差异性,因此,将X线及MRI两项检查结合起来是诊断触诊阴性而含有钙化灶早期乳腺癌的有效方法。

Objective:To investigate the role of 3.0T MRI combined with X-ray examination in the diagnosis of breast cancer with palpation-negative calcification,and to summarize and analyze the imaging features.Methods:52 cases of preoperative X-ray locating and postoperative pathologic confirmed were analysed.52 cases with calcifications were randomly divided into study group(26 cases)and control group(26 cases).For the study group.X-ray and MRI were performed before operation.And the control group only underwent X-ray examination before surgery,no MRI was performed.The breast cancer detection rate of the two groups was compared and analyzed.Results:In 52 cases,calcification distribution was linear in 4 cases,sectional in 5 cases,cluster in 12 cases,regional in 30 cases and diffuse in 1 case;There were 4 cases of amorphous calcification,15 cases of uneven roughness,27 cases of fine polymorphic calcification and 6 cases of fine line branching;In the study group,9 cases were pathologically confirmed as invasive ductal carcinoma,3 cases were intraductal carcinoma,1 case was Paige's disease,7 cases were cystic hyperplasia with cyst,and 4 cases were fibrosis with fibroadenomas,1 case was mastitis,1 case was ductal dilatation with ductitis.In the control group,there were 2 cases of invasive ductal carcinoma,2 cases of intraductal carcinoma,1 case of phyllodes tumor,4 cases of fibrosis with fibroadenomas,12 cases of cystic hyperplasia with cyst,2 cases of mastitis,and 3 cases of ductal dilatation with ductitis,there was a significant difference in the detection of breast cancer between the two groups(P≤0.01).Conclusion:For suspected calcification,if MRI is performed before X-ray localization,X-ray biopsy will greatly improve the detection rate of early breast cancer and avoid excessive calcification biopsy if abnormal enhancement is found in the calcification area.This study shows that the combination of X-ray and MRI examinations has a significant difference in the detection of breast cancer compared with the simple X-ray examination.Therefore,the combination of X-ray and MRI is an effective method for diagnosis of early breast cancer with palpation-negative calcification.