乳腺X线摄影联合MRI-DWI对非肿块型乳腺癌的评估分析

Evaluation of X-ray molybdenum target combined with MRI-DWI for non-mass breast cancer

目的探讨乳腺X线摄影联合磁共振弥散加权成像(MRI-DWI)对非肿块型乳腺癌(NMBC)的评估分析。方法选取高度疑似NMBC的患者110例,所有患者均接受乳腺X线摄影、MRI-DWI及乳腺穿刺活检检查。以乳腺穿刺活检结果作为金标准,探讨乳腺X线摄影联合MRI-DWI对NMBC的评估分析。结果经乳腺穿刺活检确诊,110例高度疑似NMBC患者中,NMBC患者90例(81.82%),非NMBC患者20例(19.18%)。乳腺X线摄影、MRI-DWI诊断NMBC与金标准的一致性Kappa值分别为0.572、0.622,一致性一般。乳腺X线摄影联合MRI-DWI诊断NMBC与金标准的一致性Kappa值为0.809,一致性好。三组灵敏度、准确度比较,乳腺X线摄影联合MRI-DWI>MRI-DWI>乳腺X线摄影,差异有统计学意义(P<0.05)。NMBC组微小钙化、结构扭曲占比显著高于非NMBC,ADC值低于非NMBC组,差异有统计学意义(P<0.05)。结论乳腺X线摄影联合MRI-DWI评估NMBC效能较高,可为临床NMBC诊治提供参考。

Objective To investigate the evaluation of non-mass breast cancer(NMBC)by X-ray molybdenum target combined with magnetic resonance imaging-diffusion weighted imaging(MRI-DWI).Methods 110 highly suspected NMBC patients were selected as the study subjects.All patients underwent X-ray molybdenum target,MRI-DWI,and breast biopsy examinations.The results of breast biopsy were used as the gold standard to explore the evaluation and analysis of X-ray molybdenum target combined with MRI-DWI for NMBC.Results Among 110 highly suspected NMBC patients diagnosed by breast puncture biopsy,90 cases(81.82%)were NMBC patients.20 were non NMBC patients(19.18%).The Kappa values of consistency between mammography and MRI-DWI in the diagnosis of NMBC and the gold standard were 0.572 and 0.622,respectively,and the consistency was general.The Kappa value of mammography combined with MRI-DWI in the diagnosis of NMBC and the gold standard was 0.809,and the consistency was good.As the sensitivity and accuracy of the three groups were compared,the results were as follows:mammography combined with MRI-DWI>MRI-DWI>mammography(P<0.05).The proportion of microcalcification and structural distortion in NMBC group was significantly higher than that in non-NMBC group.ADC value was lower than that of non-NMBC group(P<0.05).Conclusion The combination of X-ray molybdenum target and MRI-DWI has a high efficacy in evaluating NMBC,which can provide reference for the clinical diagnosis and treatment of NMBC.