摘要
目的探讨乳腺X线摄影及乳腺动态增强磁共振(DCE-MRI)对乳腺微钙化病变的诊断价值。方法回顾性分析我院2014年7月~2018年11月67例患者(78个病灶)乳腺X线摄影发现微钙化,完成MRI动态增强检查后,行立体定位核心针穿刺活检,以术后病理诊断为标准,采用卡方检验对比乳腺X线摄影、DCE-MRI及两种方法相结合对微钙化病变的诊断效能,并分析微钙化病变在乳腺X线摄影中的形态、分布特点及在DCE-MRI中的强化特点。结果对于微钙化病变,乳腺X线摄影与DCE-MRI诊断效能比较,其中特异度存在统计学差异(χ~2=4.288,P=0.038),乳腺X线摄影明显高于DCE-MRI;而乳腺X线摄影结合DCE-MRI检查比单独应用乳腺X线摄影或者DCE-MRI灵敏度、阴性预测值高。乳腺X线摄影微钙化的形态在乳腺良、恶性病变中差异有统计学意义(χ~2=13.472,P=0.004),微钙化形态与分布组合在乳腺良、恶性病变中的差异具有统计学差异(χ~2=31.047,P=0.003)。结论对于微钙化病变乳腺X线摄影较DCE-MRI诊断效能高,其中微钙化的形态比分布对乳腺良、恶性病变鉴别更具有价值,而形态与分布联合应用会进一步增加诊断准确率。乳腺X线摄影与MRI联合应用,可以提高良、恶性病变诊断效能。
Objective To evaluate suspicious microcalcifications by using mammography, dynamic contrast-enhanced magnetic resonance imaging(DCE MRI), and a combination of both methods. Methods This restrospective study included 67 patients with 78 BI-RADS 4~5 mammographic microcalcifications. All patients underwent DCE MRI before Stereotactic core needle biopsy(SCNB). Standard of reference had to be established by histopathology. Diagnostic performances of mammography and DCE MRI were evaluated, as well as the combination of the respective imaging findings. Results The specificity of mammography was significantly higher than the DCE MRI(χ~2=4.288, P=0.038). The sensitivity and NPV(negative predictive value) of combination of findings were higher than that of mammography or DCE MRI alone. There was a statistically difference in the morphology of microcalcifications between the breast benign and malignant lesions(χ~2=13.472, P=0.004). Additionally, there were statistically differences in the morphology and distribution of the microcalcifications between breast benign and malignant lesions(χ~2=31.047, P=0.003). Conclusion Mammograghy gave better diagnostic accurary for breast microcalcifications compared with DCE MRI. The morphology and the combination of morphous and distribution of microcalcifications are very important for us to diagnose and differentially diagnose them. In brief, the combination of mammography and DCE MRI could improve the diagnostic accuracy of breast microcalcifications.
作者
许梅
弋春燕
林小慧
胡根文
胡锦涛
马捷
XU Mei;YI Chunyan;LIN Xiaohui;HU Genwen;HU Jintao;MA Jie(Department of radiology,Shenzhen People’s Hospital,Second Clinical Medical College of Jinan University,Shenzhen 518020,P.R.China)
出处
《医学影像学杂志》
2019年第11期1914-1918,共5页
Journal of Medical Imaging
基金
深圳市科技计划项目(编号:JCYJ20180305164740612)
关键词
乳腺肿瘤
乳腺X线摄影
磁共振成像
微钙化
Breast neoplasms
Mammography
Magnetic resonance imaging
Microcalcification
作者简介
许梅(1994-),女,广东湛江人,毕业于广东医科大学,本科学历,现为暨南大学研究生在读,主要从事医学影像诊断工作;通信作者:马捷,主任医师,E-mail:1798045437@qq.com。
