3.0T高场磁共振与乳腺钼靶检查对乳腺癌的诊断价值探讨

Diagnostic Value of 3.0T High MRI and Molybdenum Mammography in Breast Cancer

目的探讨3.0T高场磁共振与乳腺钼靶检查对乳腺癌的诊断价值。方法选取本院2018年3月至2019年1月收治的81例乳腺癌患者,收集患者临床及影像学资料。总结乳腺癌在MRI检查和乳腺钼靶摄影检查中的图像表现,对比乳腺钼靶摄影和MRI检查对乳腺癌的准确性、灵敏性和特异性。结果乳腺钼靶摄影检查对乳腺癌的诊断灵敏性、特异性和准确性分别为62.96%、66.67%、72.84%,MRI检查对乳腺癌的诊断灵敏性、特异性和准确性分别为90.12%、93.83%、91.36%。差异有统计学意义(P<0.05)。乳腺钼靶检查图像可见形状可呈圆形、卵圆形、分叶型和不规则型,边缘清晰或模糊,可呈小分叶状、星芒状,高密度或致密肿块;不典型小结节影,隐毛刺;不规则片样纠集影;密集是呈簇样分布的泥沙样钙化灶,密度很淡;乳腺局灶性腺体结构紊乱;隐约可见的细小毛刺征;MRI检查图像可见肿块形态可呈圆形、类圆形、分叶状和不规则形;边缘光滑、不规则、星芒状(毛刺),大小不一;T1WI多表现为等高或低信号,T2WI肿块的信号多不均匀,取决于肿块内的成分;T2WI压脂多表现为高信号,但信号欠均匀;斑点状强化、均匀或不均匀强化、环形强化、非肿块样强化。结论MRI检查对乳腺癌的诊断灵敏性、特异性和准确性要优于乳腺钼靶摄影,无辐射,可作为诊断乳腺癌的重要手段,但也存在一定的不足。因此在早期乳腺癌筛查中应合理结合MRI和乳腺钼靶摄影。

Objective To explore the diagnostic value of 3.0T high MRI and molybdenum mammography in breast cancer.Methods 81 patients with breast cancer admitted to our hospital from March 2018 to January 2019 were enrolled.Clinical and imaging data were collected.To summarize the image manifestations of breast cancer in MRI and molybdenum mammography,and to compare the accuracy,sensitivity,and specificity of MRI and molybdenum mammography for breast cancer.Results The sensitivity,specificity,and accuracy of molybdenum mammography for breast cancer were 62.96%,66.67%,and 72.84%,respectively.The sensitivity,specificity,and accuracy of MRI examination for breast cancer were 90.12%,91.36%,and 93.83%,respectively.The difference was statistically significant (P<0.05).The image of molybdenum mammography showed that the shape can be round,oval,lobulated,and irregular,edge was clear or blurred,and showed small lobulated,star-shaped,high-density or dense lumps.The image showed atypical nodule shadows,hidden burrs,and irregular patchy shadow.The intensive is lesion of calcifications like sand with cluster-like distribution,the density is very light.The focal glandular structure of breast was disorder.Small burr signs were faintly visible.MRI images showed that the shape of the mass could be round,round,lobulated,and irregular,the edges were smooth,irregular,star-shaped (burr),and the size was different.T1WI showed equivalent or low signals.The signal of T2WI mass was uneven,depending on the components in the tumor.T2WI fat saturation showed high signal,but the signal was not uniform.And images showed that spotted enhancement,uniform or uneven enhancement,enhancement like ring and non-mass-like enhancement.Conclusion The sensitivity,specificity,and accuracy of MRI examination for breast cancer were better than molybdenum mammography,without radiation,and it can be used as an important means to diagnose breast cancer,but there are certain deficiencies.Therefore,MRI and mammography should be properly combined in early screening of breast cancer.