乳腺中间性钙化的MRI研究
摘要
目的:探讨乳腺MRI检查对乳腺X线之中间性钙化良、恶性病变的鉴别诊断价值。方法:收集2013年10月至2014年10月在本院行乳腺X线检查中间性钙化患者74例80个病灶为研究组,术前行MRI检查,对照组为2012年1月至2014年10月在乳腺X线表现为中间性钙化,而未作MRI检查的患者102例109个病灶,两组均接受手术切除,并以病理结果为金标准,比较两组结果 (研究组术前MRI、对照组X线)对中间性钙化恶性病变的阳性预测值及准确性。结果 :研究组病理检出良、恶性病灶分别为56、24个,MRI检查对中间性钙化恶性病变的阳性预测值为41.4%,准确性为57.5%,灵敏度为100.0%,特异度为39.3%,阴性预测值为100.0%;对照组病理检出良、恶性病灶分别为81、28个,乳腺X线对中间性钙化恶性病变的阳性预测值及准确性均为25.7%;MRI恶性阳性预测值及准确性均明显高于X线,二者之间差异有统计学意义(v=1,χ~2=4.35,P<0.05及v=1,χ~2=19.6,P<0.01)。结论:MRI检查对乳腺X线摄影之中间性钙化良、恶性病变有较好的鉴别诊断价值,可提高活检恶性阳性率。
引文
[1]中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范(2013版)[J].中国临床肿瘤学进展,2013,8:210-248.
[2]FONDRINIER E,LORIMIER G,GUERIN BOBLET V,et al.Breast micro-calcifications:multivariate analysis of radiologic and clinical factors for carcinoma[J].World J Surg,2002,26(3):290-296.
[3]郭旭辉,刘慧,孙献甫,等.X线立体定位真空辅助空芯针活检术在诊断乳腺微小钙化病变中的作用[J].肿瘤,2012,32(3):214-217.
[4]汪登斌,李志,王丽君,等.MRI对乳腺X线摄影中合成簇微钙化病变的诊断[J].放射学实践,2012,27(10):1089-1094.
[5]FIASCHETTI V,PISTOLESE CA,PERRETTA T,et al.3-5BI-RADs Microcalcifications:Correlation between MRI and Histological Findings[J].ISR Oncol,2011:643890.
[6]勾素华,朱红,申大光,等.乳腺癌MR动态增强与肿瘤微血管密度的相关性研究[J].广西医科大学学报,2010,27(4):562-564.
[7]MOUKHTAR FZ,ABU EL MAATI AA.Apparent diffusion coefficient values as an adjunct to dynamic contrast enhanced MRI for discriminating benign and malignant breast lesions presenting as mass and non-mass likeenhancement[J].The Egyptian Journal of Radiology and Nuclear Medicine,2014,45:597-604.
[8]PEDICONI F,CATALANO C,ROSELLI A,et al.Contrastenhanced MR ma mmography for evaluation of the contralateral breast in patients with diagnosed unilateral breast cancer or highrisk lesions[J].Radiology,2007,243(3):670-680.
[9]赵桂娇,付旷,郭丽丽,等.3.0T磁共振动态增强曲线与早期强化率对乳腺病变良恶性的鉴别诊断价值[J].中国实验诊断学,2013,17(1):72-75.
[10]许玲辉,彭卫军,顾雅佳.乳腺导管原位癌的MRI表现[J].中华放射学杂志,2011,45(2):159-163.
[2]FONDRINIER E,LORIMIER G,GUERIN BOBLET V,et al.Breast micro-calcifications:multivariate analysis of radiologic and clinical factors for carcinoma[J].World J Surg,2002,26(3):290-296.
[3]郭旭辉,刘慧,孙献甫,等.X线立体定位真空辅助空芯针活检术在诊断乳腺微小钙化病变中的作用[J].肿瘤,2012,32(3):214-217.
[4]汪登斌,李志,王丽君,等.MRI对乳腺X线摄影中合成簇微钙化病变的诊断[J].放射学实践,2012,27(10):1089-1094.
[5]FIASCHETTI V,PISTOLESE CA,PERRETTA T,et al.3-5BI-RADs Microcalcifications:Correlation between MRI and Histological Findings[J].ISR Oncol,2011:643890.
[6]勾素华,朱红,申大光,等.乳腺癌MR动态增强与肿瘤微血管密度的相关性研究[J].广西医科大学学报,2010,27(4):562-564.
[7]MOUKHTAR FZ,ABU EL MAATI AA.Apparent diffusion coefficient values as an adjunct to dynamic contrast enhanced MRI for discriminating benign and malignant breast lesions presenting as mass and non-mass likeenhancement[J].The Egyptian Journal of Radiology and Nuclear Medicine,2014,45:597-604.
[8]PEDICONI F,CATALANO C,ROSELLI A,et al.Contrastenhanced MR ma mmography for evaluation of the contralateral breast in patients with diagnosed unilateral breast cancer or highrisk lesions[J].Radiology,2007,243(3):670-680.
[9]赵桂娇,付旷,郭丽丽,等.3.0T磁共振动态增强曲线与早期强化率对乳腺病变良恶性的鉴别诊断价值[J].中国实验诊断学,2013,17(1):72-75.
[10]许玲辉,彭卫军,顾雅佳.乳腺导管原位癌的MRI表现[J].中华放射学杂志,2011,45(2):159-163.