乳腺钼靶联合多模态磁共振成像对非肿块型乳腺病变的诊断价值

Diagnostic value of mammography combined with multimodal magnetic resonance imaging for non-mass breast lesions

目的分析乳腺钼靶联合多模态磁共振成像(MRI)对非肿块型乳腺病变的诊断价值。方法抽取2019年5月至2021年12月焦作市人民医院收治的非肿块型乳腺病变患者91例,均采用乳腺钼靶、多模态MRI检查。以术后病理结果为"金标准",比较乳腺钼靶、多模态MRI单项和联合诊断的结果及诊断效能,比较病理检查、乳腺钼靶、多模态MRI测量的病灶长径,比较不同性质乳腺病变的表观弥散系数(ADC)。结果91例非肿块型乳腺病变患者中,病理结果证实恶性34例,良性57例;乳腺钼靶诊断出恶性24例,良性40例;多模态MRI诊断出恶性26例,良性42例;二者联合诊断出恶性32例,良性39例。乳腺钼靶与多模态MRI诊断非肿块型乳腺病变性质的特异度(70.59%比73.68%)、误诊率(29.82%比26.32%)和准确度(70.33%比74.73%)比较,差异未见统计学意义(P>0.05)。但乳腺钼靶、多模态MRI联合诊断灵敏度(94.12%)高于二者单项诊断(70.59%、76.47%),漏诊率(5.88%)低于二者单项诊断(29.41%、23.53%),P<0.05。术后病理结果、乳腺钼靶、模态MRI测量的病灶长径,三者比较差异有统计学意义(F=96.93,P<0.05),但多模态MRI与病理结果比较差异未见统计学意义(P>0.05)。非肿块型乳腺病变良性者与恶性者Fast ADC比较差异未见统计学意义(P>0.05),恶性者Standard ADC、Slow ADC均低于良性者(P均<0.05)。结论乳腺钼靶联合多模态MRI在诊断非肿块型乳腺病变性质中效果显著,对非肿块型乳腺恶性病变的灵敏度高,且不同病变性质的多模态MRI ADC值存在显著差异,联合诊断可提供更多诊断信息,避免临床漏诊。

Objective To analyze the diagnostic value of mammography combined with multimodal magnetic resonance imaging(MRI)for non-mass breast lesions.Methods A total of 91 patients with non-mass breast lesions who admitted to Jiaozuo People’s Hospital from May 2019 to December 2021 were selected,and all selected patients underwent mammography examination and multimodal MRI.Taking postoperative pathological results as the gold standard,the results and diagnostic efficacy of mammography,multimodal MRI,and combination of them in the diagnosis of non-mass breast lesions were compared.And the major diameter of lesions detected by pathological examination,mammography,and multimodal MRI were compared.The apparent diffusion coefficients of breast lesions of different natures were compared.Results Among the 91 patients with non-mass breast lesions,34 cases were malignant,and 57 cases were benign according to pathological results.Twenty-four malignant cases and 40 benign cases were diagnosed by mammography;26 malignant cases and 42 benign cases were diagnosed by multimodal MRI;32 cases were malignant,and 36 cases were benign according to the combination of the two examinations.There was no difference in the specificity(70.59%vs.73.68%),misdiagnosis rate(29.82%vs.26.32%)and accuracy(70.33%vs.74.73%)in diagnosing the nature of non-mass breast lesions between mammography and multimodal MRI(P>0.05).However,the diagnostic sensitivity of mammography combined with multimodal MRI(94.12%)was higher than that of the two single diagnotic methods(70.59%,76.47%),P<0.05.And the missed diagnosis rate of mammography combined with multimodal MRI(5.88%)was lower than that of the two single diagnotic methods(29.41%,23.53%),P<0.05.There were significant differences in the major diameter of lesions detected by postoperative pathological results,mammography,and modal MRI(F=96.93,P<0.05),but there was no significant difference between multimodal MRI and pathological results(P>0.05).There was no significant difference in Fast ADC between benign and malignant non-mass breast lesions(P>0.05),and the Standard ADC and Slow ADC of malignant breast lesions were lower than those of benign breast lesions(all P<0.05).Conclusions Mammography combined with multimodal MRI is effective in diagnosing the nature of non-mass breast lesions,and has a high sensitivity for non-mass breast malignant lesions.There are significant differences in ADC values of multimodal MRI among lesions with different natures.Combined diagnosis can provide more diagnostic information and avoid clinical missed diagnosis.