乳腺X线摄影与彩超及磁共振成像在术前综合乳腺癌患者中的应用

Application of mammography,color ultrasound and magnetic resonance imaging in preoperative comprehensive breast cancer patients

目的探究乳腺X线摄影、彩超、磁共振成像(MRI)在术前综合乳腺癌患者中的应用。方法回顾性分析2018年5月至2020年5月于本院行乳腺癌保乳手术治疗的103例患者的临床资料,患者术前均接受乳腺X线摄影、彩超、MRI影像学检查。以术后病理结果为金标准,比较3种检查方法肿瘤最大直径、乳腺癌检出率及诊断准确率。结果MRI测量的肿瘤最大直径与实体瘤检查比较差异无统计学意义;乳腺X线摄影测量的肿瘤最大直径大于实体瘤检查,彩超测量的肿瘤最大直径小于实体瘤检查,差异有统计学意义(P<0.05)。MRI对不同象限肿瘤病灶的总检出率均高于乳腺X线摄影、彩超,差异有统计学意义(P<0.05)。MRI诊断准确率明显高于乳腺X线摄影、彩超,差异有统计学意义(P<0.05)。乳腺X线摄影影像学表现:钼靶X线头尾位及内外斜位显示乳腺内肿块影,边缘见细小短毛刺,周围乳腺结构扭曲变形,部分向病灶内延伸;彩超影像学表现:乳腺腺体组织稍增厚,小叶结构略粗大紊乱,内分布不均匀,导管未见扩张,左侧乳房象限可见低回声团块,内部回声欠均匀,形态不规则;MRI影像学表现:左乳MRI矢状位,呈边缘环状强化向中心渗透,呈向心样强化。结论与乳腺X线摄影及彩超相比,MRI可获得更高的乳腺癌检出率及诊断准确率,能为乳腺癌的术前诊断提供可靠的参考依据,值得临床推广应用。

Objective To explore application of mammography,color ultrasound and magnetic resonance imaging(MRI)in preoperative comprehensive breast cancer patients.Methods The clinical data of 103 patients who underwent breast-conserving surgery for breast cancer in our hospital from May 2018 to May 2020 were retrospectively analyzed.All patients underwent mammography,color ultrasound,and MRI imaging before surgery.The postoperative pathological results were used as the gold standard,the maximum diameter of tumor,breast cancer detection rate,and diagnostic accuracy were compared among the three methods.Results There was no significant difference in the maximum diameter of tumor measured by MRI and solid tumor examination;the maximum diameter of tumor measured by mammography was larger than that of solid tumor examination,and the maximum diameter of tumor measured by color ultrasound was smaller than that of solid tumor examination,and the differences were statistically significant(P<0.05).The total detection rate of MRI for tumor lesions in different quadrants was higher than that of mammography and color ultrasound,and the differences were statistically significant(P<0.05).The diagnostic accuracy of MRI was significantly higher than that of mammography and color ultrasound,and the differences were statistically significant(P<0.05).Mammography imaging findings:molybdenum target X-ray head and tail position and internal and external oblique showed breast mass shadow,edge see small short burr,distortion of the surrounding breast structure,part of the extension to the lesion;color ultrasound imaging findings:slightly thickened breast glandular tissue,lobular structure slightly thick disorder,uneven distribution,no expansion of the catheter,the left breast quadrant visible low echo mass,internal echo is not uniform,irregular shape;MRI imaging findings:left breast MRI sagittal position,showing edge ring enhancement to the center of the infiltration,showing centripetal enhancement.Conclusion Compared with mammography and color ultrasound,MRI can obtain higher detection rate and diagnostic accuracy of breast cancer,and provide reliable reference for preoperative diagnosis of breast cancer,it is worthy of clinical application.