ISSN 1004-4140
CN 11-3017/P

乳腺钼靶上含钙化占位性病变的动态增强MRI研究

Diagnostic Value of DCE-MRI for Breast Occupying Lesions with Calcification Detected by Mammography

  • 摘要: 目的:探讨动态增强MRI对乳腺钼靶上含钙化占位性病变的诊断价值。资料与方法:回顾性分析101例乳腺含钙化占位性病变的钼靶及MRI检查资料。其中,乳腺恶性占位性病变56例,包括浸润性导管癌46例,导管原位癌3例,小叶原位癌2例,粘液腺癌3例,基底细胞癌1例,肌上皮癌1例;乳腺良性占位性病变45例,包括乳腺纤维腺瘤39例,乳腺囊肿4例,乳腺纤维囊性增生2例。根据钼靶上钙化形态对于良恶性病变的判断标准,将钙化分为典型良性、可疑恶性、高度可能恶性三类。将钼靶和MRI的诊断结果与病理诊断结果进行对照。以病理结果为金标准,对钼靶与MRI的诊断结果进行配对四格表χ2检验统计学分析。结果:本组85例患者(84.2%)根据钼靶所见做出正确诊断。16例患者(15.8%)钼靶提示可疑恶性钙化但未能确诊或误诊,其中14例在MRI检查后做出正确诊断。MRI检查做出正确诊断99例(98.0%)。钼靶和MRI检查对本组含钙化乳腺占位性病变的诊断准确率差异有统计学意义(P=0.0005,P<0.O5)。结论:当钼靶上钙化信息不能明确乳腺占位性病变的性质,特别在钙化归为BI-RADS3和BI-RADS4级乳腺疾病时,动态增强MRI可以提高诊断准确性。

     

    Abstract: Objective:To evaluate the diagnostic value of dynamic enhanced MRI(DCE-MRI) for breast occupying lesions with calcification detected by mammography.Materials and methods Mammography and MRI data of 101 patients with breast occupying lesions containing calcification were retrospectively analyzed.Fifty six cases were malignant,including 46 cases with invasive ductal carcinoma,3 cases with ductal carcinoma in situ,2 cases with lobular carcinoma in situ,3 cases with mucous adenocarcinoma,1 case with basal cell carcinoma,1 case with myoepithelial carcinoma.Benign lesions were 45 cases,including 39 cases with breast fibroadenoma,4 cases with cyst,2 cases with fibrocystic breast hyperplasia.According to the diagnostic standard,the form of calcification was divided into three categories,including typical benign,suspicious and high suspicious malignant.The diagnosis of mammography and MRI was compared with the pathologic diagnosis,which was regarded as gold standard.The diagnostic results of mammography and MRI were statistically analyzed using McNemar's Test.Results 85 cases(84.2%) were correctly diagnosed,while 16 cases(15.8%) were misdiagnosed or diagnosed as suspicious malignant calcification by mammography.Among the 16 cases,14 of them were correctly diagnosed following DCE-MRI examination,total 99 cases were correctly diagnosed by DCE-MRI.The difference of diagnostic results based on mammography and MRI findings was significant(P = 0.0005,P< 0.05).Conclusion:When it is difficult to make a definite diagnosis for breast occupying lesions with calcification after mammography,especially for those patients with lesions in BI-RADS 3 and 4,DCE-MRI is helpful in improving diagnostic accuracy.

     

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