MRI、超声对乳腺非肿块样强化病变诊断价值比较

Comparison on the Diagnostic Value of MRI and Ultrasound for Non-mass Like Enhancement Lesions

目的探讨磁共振成像(MRI)、超声对乳腺非肿块样强化(NMLE)病变诊断价值比较。方法选取2017年6月至2019年5月本院收治的98例乳腺NMLE病变患者为研究对象,所有患者均行MRI、超声检查及病理学诊断,分析患者MRI、超声检查影像学表现及两者的诊断价值。结果98例乳腺NMLE病变患者中,经病理学诊断确诊14例(14.29%)为良性病变,84例(85.71%)诊断为恶性病变;MRI诊断乳腺NMLE病变良恶性的灵敏度、准确度、阴性预测值均高于超声检查,其中两种检查方法的灵敏度存在明显差异(P<0.05),且MRI诊断与病理诊断的Kappa值为0.785,大于超声诊断与病理诊断的Kappa值0.621。结论超声诊断乳腺NMLE病变虽然敏感度较低,但是操作便捷,可重复性强,常作为筛查乳腺病变的首选检查手段;MRI诊断乳腺NMLE病变良恶性具有更高的灵敏度、准确率,临床上应结合实际情况予以综合应用。

Objective To explore the diagnostic value of magnetic resonance imaging(MRI)and ultrasound for nonmass like enhancement(NMLE)lesions.Methods A total of 98 patients with breast NMLE lesions admitted to the hospital were enrolled as the research objects between June 2017 and May 2019.All underwent MRI examination,ultrasound examination and pathological diagnosis.The imaging findings and diagnostic value of MRI and ultrasound were analyzed.Results Among the 98 patients with breast NMLE lesions,there were 14 cases(14.29%)with benign lesions and 84 cases(85.71%)with malignant lesions confirmed by pathological diagnosis.The sensitivity,accuracy and negative predictive value of MRI in the diagnosis of benign and malignant breast NMLE lesions were higher than those of ultrasound.There were significant differences in sensitivity between the two methods(P<0.05).Kappa value between MRI and pathological diagnosis was 0.785,greater than that between ultrasound and pathological diagnosis(0.621).Conclusion Although the sensitivity of ultrasound is relatively lower in the diagnosis of breast NMLE lesions,the operation is easy and repeatability is strong,which is often applied as the preferred screening method for breast lesions.The sensitivity and accuracy rates of MRI are higher in the diagnosis of breast NMLE lesions.They should be comprehensively applied in clinical practice.