全数字化乳腺摄影联合乳腺MRI动态增强对乳腺癌的诊断价值

冯奇科+张金梅+伍尚波

[摘要] 目的 总结乳腺癌在全数字化乳腺摄影（FFDM）与乳腺MRI动态增强检查中的影像学特点及其联合应用诊断价值，提高对乳腺癌的诊断水平。 方法 回顾性分析33例经手术病理证实的乳腺癌患者，术前1周内进行FFDM及乳腺MRI动态增强检查并参照乳腺影像报告数据系统（BI-RADS）及BI-RADS-MRI标准分级，以4C、5级为FFDM和乳腺MRI动态增强诊断乳腺癌阳性指标，计算两种方法各自诊断乳腺癌准确率以及联合应用准确率。 结果 25例乳腺癌病灶FFDM诊断与病理结果相符，准确率为75.76%；30例乳腺癌病灶乳腺MRI动态增强诊断与病理结果相符，准确率为90.91%；两种方法联合运用检出乳腺癌32例，准确率96.97%。各种准确率差异有统计学意义（P＜0.05）。 结论 FFDM与乳腺MRI动态增强联合应用于乳腺癌的诊断，有助于提高对乳腺癌的诊断准确性。

[关键词] 乳腺癌；全数字化乳腺摄影；乳腺MRI动态增强

[中图分类号] R737.9[文献标识码] A[文章编号] 1674-4721（2014）03（c）-0106-03

Diagnosis value of combined full-field digital mammography and breast MRI dynamic enhancement for breast cancer

FENG Qi-ke ZHANG Jin-mei WU Shang-bo

Department of Radiology,Maternal and Child Care Service Center of Yunfu City in Guangdong Province,Yunfu 527300,China

[Abstract] Objective To summarize the imaging features of breast cancer in full-field digital mammography(FFDM) and breast MRI dynamic enhancement examination and the diagnosis value of their combined application in order to improve the diagnosis level of breast cancer. Methods 33 patients with breast cancer confirmed by pathology were analyzed retrospectively and all received FFDM and breast MRI dynamic enhancement examination within one week before surgery.Referring to the breast imaging reporting and data system(BI-RADS) and the BI-RADS-MRI grading standards,and taking 4C and grade 5 as the positive indicators of FFDM and breast MRI dynamic enhancement diagnosis,the respective accuracy rates of the two methods and the combined application accuracy rate were calculated. Results 25 cases of breast cancer lesions diagnosed by FFDM were consistent with the pathological results,with the accuracy rate of 75.76%;30 cases of breast cancer lesions diagnosed by breast MRI dynamic enhancement examination were consistent with the pathological results,with the accuracy rate of 90.91%;32 cases of breast cancer lesions detected by the combined application were consistent with the pathological results,with the accuracy rate of 96.97%;there were statistically significant differences(P＜0.05). Conclusion The combined application of FFDM and breast MRI dynamic enhancement examination in the diagnosis of breast cancer is conducive to improving the diagnosis accuracy of breast cancer.

[Key words] Breast cancer;Full-field digital mammography;Breast MRI dynamic enhancement

乳腺癌是当今妇女最常见的恶性肿瘤，占女性肿廇总数的7%～10%，同时乳腺癌也是当今妇女中除肺癌以外死亡率最高的恶性肿瘤。乳腺癌发病率呈逐年上升趋势，全球每年发病率超过120万人[1-2]，我国乳腺癌发病率以每年超过3%的速度上升，其增长率已超过西方国家。国内大城市乳腺癌占女性恶性肿瘤的第1位。本研究回顾性分析有完整临床资料并经手术病理证实的33例乳腺癌患者，探讨全数字化乳腺摄影（full field digital mammography，FFDM）、乳腺MRI动态增强影像学特点，并与病理结果进行对照分析，评价FFDM、乳腺MRI动态增强术前乳腺影像报告数据系统（breast imaging reporting and data system，BI-RADS）分级正确率，以提高诊断水平。……