MRI、钼靶及超声引导下穿刺活检在鉴别乳腺肿块良恶性的应用价值研究

Application Value of MRI,Mammography and Ultrasound-guided Biopsy in the Diagnosis and Differentiation of Benign and Malignant Lesions of Breast Masses

目的探讨磁共振成像(MRI)、钼靶及超声引导下穿刺活检在鉴别乳腺肿块良恶性病变中的应用价值。方法收集我院2018年1月至2019年1月83例因乳腺肿块良恶性病变来我院就诊患者的临床资料,患者均接受MRI、钼靶及超声引导下穿刺活检,以病理活检结果为金标准,计算MRI、钼靶诊断乳腺肿块良恶性病变的灵敏度、特异度、准确度及与穿刺活检结果的一致性。结果83例患者超声引导下穿刺活检显示良性病变62例,恶性病变21例。以超声引导下穿刺活检结果为标准,MRI诊断恶性病变灵敏度为95.24%,特异度为98.39%,准确度为97.59%,与穿刺活检结果一致性显示Kappa值=0.936;钼靶诊断恶性病变灵敏度为76.19%,特异度为87.10%,准确度为84.34%,与穿刺活检结果一致性显示Kappa值=0.604。结论以超声引导下穿刺活检的病理结果为参考标准,MRI诊断乳腺肿块良恶性病变的诊断效能比钼靶更高。

Objective To explore the application value of magnetic resonance imaging(MRI),mammography and ultrasound-guided biopsy in the diagnosis and differentiation of benign and malignant lesions of breast masses.Methods The clinical data of 83 patients with benign and malignant breast lesions from January 2018 to January 2019 were collected.All patients were given MRI,mammography and ultrasound-guided biopsy examination.The pathological biopsy results were regarded as the gold standards to calculate the sensitivity,specificity and accuracy of MRI and mammography in the diagnosis of benign and malignant breast lesions and the consistency with the biopsy results.Results Ultrasound-guided biopsy of 83 patients showed 62 benign lesions and 21 malignant lesions.Taking ultrasound-guided biopsy results as the standards,the sensitivity,specificity and accuracy of MRI in the diagnosis of malignant breast masses were 95.24%,98.39%and 97.59%,and its consistency with biopsy results showed the Kappa value was 0.936.The sensitivity,specificity and accuracy of mammography in the diagnosis of malignant breast masses were 76.19%,87.10%and 84.34%,and its consistency with biopsy results showed Kappa value was 0.604.Conclusion Taking the pathological results of ultrasound-guided biopsy as the reference standard,MRI has higher diagnostic efficiency than mammography in the diagnosis of benign and malignant breast masses.