三维超声与磁共振成像对乳腺肿块鉴别诊断价值

Differential diagnostic value of three-dimensional ultrasound and magnetic resonance imaging in breast lesions

关键词:  三维超声  磁共振成像  乳腺肿瘤  诊断

Key words:  three-dimensional ultrasound  MRI  breast tumor  diagnosis

摘要:

目的研究三维超声成像（three dimensional ultrasonography, 3DUS）及磁共振成像（magnetic resonance image, MRI）对乳腺良恶性肿瘤鉴别诊断的价值。方法回顾性分析经手术切除病理确诊的112名患者，125例乳腺肿块的临床数据，术前均分别行二维超声、三维超声及MRI检查，根据“乳腺影像报告和数据系统”（Breast Imaging Reporting and Data System, BI-RADS）对肿块进行分类，并对三维超声及MRI诊断价值进行对照．结果125例乳腺肿块经病理证实，恶性69例，良性56例；三维超声对乳腺恶性肿块诊断的敏感性、特异性、阳性预测值、阴性预测值、准确率分别为89．9％、71．4％、79．5％、85．1％、81．6％；MRI对乳腺恶性肿块诊断的敏感性、特异性、阳性预测值、阴性预测值、准确率分别为88．4％、78．9％、85．9％、84．6％、84．0％。两种影像学检查方法对乳腺恶性肿块诊断价值的差异无统计学意义。结论三维超声及MRI在乳腺良恶性肿块鉴别诊断中具有重要临床价值，两者互补可提高诊断准确率。

Abstract:

Objective To assess the differential diagnostic value of three-dimensional ultrasound （3D- US） and magnetic resonance imaging （MRI）in breast lesions. Methods The clinical data of 125 cases of breast lesions were retrospective analyzed. All patients underwent two-dimensional ultrasound, three-dimensional ultrasound and MRI examinations preoperatively. The imaging findings were classified according to Breast Imaging Reporting and Data System （BI-RADS）. The diagnostic values of 3D-US and MRI were evaluated using pathological results as gold standard. Results The breast lesions were confirmed by pathology, including 56 cases of benign masses and 69 cases of malignancy. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 3D-US in diagnosis for breast malignancy was 89.9%, 71.4%, 79.5%, 85. 1%, 81.6%, respectively; which had no significant differences with those of MRI（88.4%, 78.9%, 85.9%, 84.6% , 84.0%, respectively）. Conclusion The applications of 3D-US and MRI are of value in differential diagnosis of breast lesions, and the combination of two methods may increase the accuracy of diagnosis.