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1. 上海交通大学医学院附属新华医院超声科,上海,200092
2. 上海交通大学医学院附属新华医院放射科,上海,200092
3. 上海交通大学医学院附属新华医院病理科,上海,200092
网络首发:2017-12-08,
纸质出版:2017-12-08
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董维露, 陈亚青, 蒋珺, 等. 常规超声与MRI对乳腺X线摄影阴性乳腺癌诊断价值的对比研究[J]. 肿瘤影像学, 2017,26(5):326-331.
董维露,陈亚青,蒋珺,等. 常规超声与MRI对乳腺X线摄影阴性乳腺癌诊断价值的对比研究[J]. 肿瘤影像学, 2017, 26(5): 326-331
目的:
比较常规超声与MRI对乳腺X线摄影阴性乳腺癌的诊断价值。
方法:
收集上海交通大学医学院附属新华医院乳腺X线摄影检查阴性,并接受常规超声及MRI检查的乳腺疾病患者257例共305个病灶,以术后病理为对照,回顾性分析常规超声与MRI检查对乳腺X线摄影阴性乳腺病灶的检出率及诊断价值。
结果:
常规超声和MRI对乳腺X线摄影阴性乳腺病灶的总检出率分别为97.38%和90.49%。MRI对导管内病灶的检出率高于常规超声(98.21%和75.00%,
P
<0.05),两种方法对肿块型病灶的检出率无统计学差异(97.19% 和93.98%,
P
>0.05)。常规超声和MRI对乳腺X线摄影阴性乳腺癌诊断的灵敏度、特异度、准确率分别为85.37%、74.62%、76.07%,90.24%、58.71%、62.95%,常规超声对乳腺X线摄影阴性乳腺癌的诊断特异度和准确率高于MRI(
P
<0.001)。常规超声和MRI诊断乳腺X线摄影阴性乳腺癌的受试者工作特征(receive operating characteristic,ROC)曲线下面积分别为0.800和0.745,无统计学差异(
P
>0.05)。
结论:
常规超声和MRI对乳腺X线摄影阴性乳腺病灶均具有较高的检出率,其中MRI对导管内病灶的检出率优于常规超声,但常规超声与MRI对乳腺X线摄影阴性乳腺癌的诊断效能相仿,因此常规超声可作为乳腺X线摄影阴性患者的首选检查方法。
Objective:
To compare the diagnostic value of ultrasound and magnetic resonance imaging (MRI) in breast cancer with negative mammography.
Methods:
A total of 305 lesions from 257 mammography-negative patients who underwent ultrasound and MRI examinations were retrospectively analyzed. All cases were confirmed by pathology after surgery. The differences in the detection rate for mammography-negative breast lesions and t
he diagnostic value for mammography-negative breast cancer between ultrasound and MRI were analyzed.
Results:
The detection rate of MRI and ultrasound for all mammographynegative lesions was 97.38% and 90.49%
respectively. MRI had the higher detection rate than ultrasound for intraductal lesions (98.21% vs. 75.00%
P
0.05)
and there was no significant difference between the two methods in the detection rate of mass-like lesions (97.19% vs. 93.98%
P
0.05). The sensitivity
specificity and accuracy of ultrasound and MRI in diagnosing breast cancer were 85.37%
74.62%
76.07% and 90.24%
58.71%
62.95%
respectively. The specificity and accuracy of ultrasound were higher than MRI (
P
0.001). The area under receiver operating characteristic (ROC) curves of ultrasound and MRI was 0.800 and 0.745
respectively
and there was no significant difference between the two methods (
P
0.05).
Conclusion:
Both ultrasound and MRI have a high detection rate of mammography-negative breast lesions
and MRI is superior to ultrasound in detection of mammographynegative introductal lesions. The diagnostic value of ultrasound in mammography-negative breast cancer is similar to MRI
therefore
ultrasound should be the preferred method for screening.
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