增强磁共振成像与超声弹性成像联合应用对乳腺癌的诊断价值

侯利华　张孔明　孙艳

【摘要】 目的：探讨超声弹性成像联合增强磁共振成像用于诊断乳腺癌的临床价值。方法：本次研究对象来源于本院乳腺科2013年6月-2016年6月收治的乳腺癌患者65例（74个病灶），均行超声弹性成像联合增强磁共振成像检查，探讨其临床价值。结果：增强磁共振成像诊断准确率为83.8%，恶性病灶表现为边缘不规则且为毛刺肿块、有光滑边缘且为类圆形、局灶簇样强化及节段样强化。UE弹性评分74个病灶诊断准确率为86.5%，恶性肿瘤中1分27个，2分37个。联合诊断准确率为91.9%，与UE单独诊断86.5%、增强磁共振成像单独诊断83.8%比较，差异均有统计学意义（P<0.05）。结论：超声弹性成像联合增强磁共振成像诊断乳腺癌临床价值高，值得推广。

【关键词】 超声弹性成像； 增强磁共振成像； 乳腺癌； 诊断价值

【Abstract】 Objective：To investigate the clinical value of Enhanced Elastography and Magnetic Resonance Imaging on Breast Cancer.Method：The image data of 65 breast tumor cases（74 lesions） were collected from June 2013 to June 2016，they were detected by enhanced elastography and magnetic Resonance imaging.Result：Enhanced elastography Imaging showed malignant lesions，which were irregular edges with burr lumps，smooth edges and similar rounds，focal cluster like enhancement and segmental enhancement，the diagnostic accuracy rate was 83.8%.74 lesions were diagnosed by UE elastic score，the accuracy of malignant tumor was 86.5%，with 27 cases of one score，37 cases of two scores.The accuracy of combined diagnostic was 91.9%，significantly higher than enhanced elastography imaging（86.5%） and magnetic resonance imaging（83.8%），the differences had statistical significance（P<0.05）.Conclusion：With high clinical value，it is worth to promot the use of enhanced elastography and magnetic resonance imaging in breast cancer.

【Key words】 Enhanced elastography imaging； Magnetic esonance maging； Breast cancer； Diagnostic value

First-authors address：The Third Peoples Hospital of Jiujiang，Jiujiang 332000，China

doi：10.3969/j.issn.1674-4985.2017.25.027

乳腺癌為临床妇科发生率较高的恶性肿瘤，据调查在各种恶性肿瘤中其发生率为7%～10%[1]，在妇科恶性肿瘤中仅次于子宫颈癌，而部分大城市经调查后其在女性恶性肿瘤中乳腺癌居于首位，近年来其发病呈现出年轻化趋势。乳腺癌为全身性疾病，早期或亚临床阶段经血液循环癌细胞会向全身扩散，对妇女身心健康及生命安全产生严重危害。早期乳腺癌无明显体征及临床症状，患者难以察觉，发现后多为晚期，生存率与手术率较低，为此一定要尽早发现与诊治，才能减少病死率，改善预后。目前影像学检查为早期筛查与诊断乳腺癌的主要手段，US（二维超声）、MRI（磁共振成像）、钼靶X线检查或CT等发展较成熟。其中US与钼靶X线检查应用最广泛，因其最简便，但钼靶X线易误诊与漏诊，且辐射剂量较大，故而应用受限。……