摘要
目的探讨全数字化乳腺摄影(FFDM)联合动态增强磁共振成像(DCE-MRI)在含钙化灶乳腺病变患者良、恶性鉴别诊断中的应用价值。方法选取2016年12月至2018年12月含钙化灶乳腺良性病变患者89例设为良性组,同期收治的含钙化灶乳腺恶性病变患者89例设为恶性组。两组均分别接受FFDM及DCE-MRI检查,统计两组病变边缘形态(光滑、毛刺、分叶、不规则)、最小表观扩散系数(ADC值)、平均ADC值、早期增强率,并统计分析FFDM及DCE-MRI检查对乳腺病变单独及联合诊断效能。结果 (1)恶性组病变边缘形态与良性组比较,差异有统计学意义(P<0.01);(2)恶性组最小ADC值、平均ADC值低于良性组(P<0.01);(3)良性组早期增强<60%率(79.78%)高于恶性组(29.21%)(P<0.01);(4)联合诊断敏感度(95.51%)、准确度(93.26%)高于FFDM(77.53%、84.83%)、DCE-MRI(82.02%、87.64%)单独诊断(P<0.05,P<0.01),联合诊断特异度(91.01%)与FFDM(92.13%)及DCE-MRI(93.26%)间无统计学差异(P>0.05)。结论含钙化灶乳腺良性及恶性病变经FFDM与DCE-MRI检查可见明显差异,而联合两种措施进行综合诊断,可提高乳腺病变鉴别诊断敏感度与准确度,最大程度降低漏诊风险。
Objective To investigate the value of full field digital mammography(FFDM) combined with dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) in differential diagnosis of benign and malignant breast lesions with calcified foci.Methods Admitting to hospital from December 2016 to December 2018,89 patients with benign breast lesions with calcified foci were enrolled in benign group,and 89 patients with calcified breast malignant lesions were enrolled in malignant group.After examination by FFDM and DCE-MRI,the marginal morphology of lesions(smooth,burr,lobulation,irregular),minimum apparent diffusion coefficient(ADC) value,average ADC value and early enhancement rate of lesions were observed in both groups.The diagnostic efficacy of separate or combined FFDM and DCE-MRI for breast lesions was also analyzed.Results The marginal morphology in malignant group was significantly different from that in benign group(P<0.01).Minimum ADC value and average ADC value in malignant group were significantly lower than those in benign group(P<0.01).The early enhancement rate(<60%) in benign group was statistically higher than that in malignant group(79.78% vs 29.21%,P<0.01).The sensitivity(95.51%) and accuracy(93.26%) of combined diagnosis of FFDM and DCE-MRI were statistically higher than those of FFDM(77.53%,84.83%) and DCE-MRI(82.02%,87.64%) respectively(P<0.05,P<0.01).The specificity of combined diagnosis(91.01%) was not significantly different from FFDM(92.13%) and DCE-MRI(93.26%)(P>0.05).Conclusion The benign and malignant breast lesions with calcification can be obviously distinguished by FFDM and DCE-MRI.Comprehensive diagnosis by FFDM plus DCE-MRI can improve the sensitivity and accuracy of differential diagnosis of breast lesions and minimize the risk of missed diagnosis.
作者
蔡亲磊
张小花
陈洋
CAI Qin-lei;ZHANG Xiao-hua;CHEN Yang(Department of Radiology,Hainan General Hospital,Haikou,Hainan 570311,China)
出处
《中国临床研究》
CAS
2019年第11期1564-1567,1570,共5页
Chinese Journal of Clinical Research
基金
海南省自然科学基金面上项目(20168274)~~
关键词
全数字化乳腺摄影
动态增强磁共振成像
含钙化灶乳腺病变
病变性质
鉴别诊断效能
表观扩散系数
早期增强率
Full field digital mammography
Dynamic contrast-enhanced magnetic resonance imaging
Calcified breast lesions
Pathological properties
Differential diagnosis efficiency
Apparent diffusion coefficient
Early enhancement rate