摘要
目的探讨乳腺X线摄影联合超声与MRI对乳腺癌的诊断价值。方法回顾性分析2015年4月至2016年12月在河北医科大学第四医院就诊的255例(260个病灶)乳腺疾病患者的X线摄影、超声及MRI诊断资料。以病理诊断为金标准,X线摄影、超声与MRI诊断结果依据BI-RADS分类,4~5类为阳性结果,采用受试者工作特征(ROC)曲线评价两者的诊断效能。采用Kappa检验评价两者诊断乳腺癌与病理诊断的一致性。结果乳腺X线摄影联合超声诊断乳腺癌的敏感度为98.6%(204/207),特异度为77.4%(41/53),准确率为94.2%(245/260),与病理诊断的一致性非常好(Kappa=0.810,P<0.001);MRI诊断乳腺癌的敏感度为98.1%(203/207),特异度为66.0%(35/53),准确率为91.5%(238/260),与病理诊断的一致性好(Kappa=0.711,P<0.001)。乳腺X线摄影联合超声和MRI诊断乳腺癌的ROC曲线下面积分别为0.902(95%CI:0.843~0.961,P<0.001)和0.893(95%CI:0.842~0.945,P<0.001),两者间差异无统计学意义(Z=0.050,P>0.050)。结论乳腺X线摄影联合超声与MRI相比,两者诊断价值相当,对乳腺癌的诊断准确率均较高。乳腺X线摄影联合超声由于简便和经济,可作为乳腺癌的首选检查方法,而MRI在乳腺癌术前评估中的作用不可替代。
Objective To assess the diagnostic efficacy of mammography(MAM)combined with ultrasonography(US)and magnetic resonance imaging(MRI)for breast cancer.Methods The imaging data(including MAM,US and MRI)of 255 patients(260 breast lesions)with breast diseases in the Fourth Affiliated Hospital of Hebei Medical University from April 2015 to December 2016 were analyzed retrospectively.Pathological diagnosis of the lesions was set as the gold standard.The diagnostic results of MAM,US and MRI are classified according to BI-RADS and the lesions of BI-RADS grades 4 and 5 were regarded positive.The receiver operating characteristic(ROC)curve was used to evaluate the diagnosis performances of the two methods.Kappa test was used to evaluate the consistency of the two methods with the pathological results.Results The sensitivity,specificity and accuracy of MAM combined with US for breast cancer diagnosis were 98.6%(204/207),77.4%(41/53)and 94.2%(245/260),respectively.The sensitivity,specificity and accuracy of MRI were 98.1%(203/207),66.0%(35/53)and 91.5%(238/260),respectively.With the pathological diagnosis as the gold standard,the Kappa value of MAM combined with US in consistency test was 0.810(P<0.001),while the Kappa value of MRI was 0.711(P<0.001).The areas under ROC curves of MAM combined with US and MRI for the diagnosis of breast lesions were 0.902(95%CI:0.843-0.961,P<0.001)and 0.893(95%CI:0.842-0.945,P<0.001),indicating no significant difference(Z=0.050,P>0.050).Conclusions MAM combined with US and MRI both have high diagnostic accuracy for breast cancer,with equivalent diagnostic value.MAM combined with US is the first choice for breast cancer patients because of its simple operation and low cost,but the role of MRI in preoperative evaluation of breast cancer is irreplaceable.
作者
荣小翠
康一鹤
时高峰
李智岗
吴勇超
武中林
Rong Xiaocui;Kang Yihe;Shi Gaofeng;Li Zhigang;Wu Yongchao;Wu Zhonglin(Department of Radiology,Fourth Affiliated Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Computed Tomography,Fourth Affiliated Hospital of Hebei Medical University,Shijiazhuang 050011,China)
出处
《中华乳腺病杂志（电子版）》
CAS
CSCD
2019年第5期281-285,共5页
Chinese Journal of Breast Disease(Electronic Edition)
基金
河北省医学科学研究重点课题资助项目(20180512)
关键词
乳腺疾病
乳房X线摄影术
超声检查
诊断
磁共振成像
Breast diseases
Mammography
Ultrasonography
Diagnosis
Magnetic resonance imaging
