切换至 "中华医学电子期刊资源库"
高级检索
中华普外科手术学杂志(电子版)

中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (05) : 480 -482. doi: 10.3877/cma.j.issn.1674-3946.2020.05.015

所属专题： 文献；

论著

MRI联合钼靶X线在乳腺导管原位癌的诊断价值
汤程旭1,†(), 陈文龙1, 杨蕊2   
  1. 1. 210048　东南大学附属中大医院（江北院区）　放射科
    2. 214000　南京医科大学附属无锡医院中心实验室
  • 收稿日期:2019-10-30 出版日期:2020-10-26
  • 通信作者: 汤程旭

The clinical value of MRI combined with mammography in the diagnosis of ductal carcinoma in situ

Chengxu Tang1,†(), Wenlong Chen1, Rui Yang2   

  1. 1. Department of Radiology, Zhongda Hospital of Southeast university (Jiangbei District), Jiangsu 210048, China
    2. Central Laboratory of Wuxi Hospital, Nanjing Medical University, Jiangsu 214000, China
  • Received:2019-10-30 Published:2020-10-26
  • Corresponding author: Chengxu Tang
  • About author:
    Corresponding author: Tang Chengxu, Email:
  • Supported by:
    National natural science foundation of China (youth project) ,(81602728)
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

汤程旭, 陈文龙, 杨蕊. MRI联合钼靶X线在乳腺导管原位癌的诊断价值[J]. 中华普外科手术学杂志(电子版), 2020, 14(05): 480-482.

Chengxu Tang, Wenlong Chen, Rui Yang. The clinical value of MRI combined with mammography in the diagnosis of ductal carcinoma in situ[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(05): 480-482.

目的

探讨MRI联合乳腺钼靶X线诊断乳腺导管原位癌的应用价值。

方法

选择2018年2月至2019年2月收治的90例乳腺导管原位癌患者，对所有患者给予乳腺钼靶X线及MRI检查，比较联合检查与单一检查的诊断价值。采用SPSS22.0进行统计分析，年龄和病灶直径计量资料采用(±s)表示，t检验；将病理诊断作为金标准，分析MRI及联合诊断的敏感度及特异度。计数资料采用n(%)表示，χ2检验，P<0.05为差异有统计学意义。

结果

90例乳腺导管原位癌患者均为单发病灶，恶性病灶48例，良性病灶42例。恶性病灶患者的年龄与良性病灶差异无统计学意义(P>0.05)，良性病灶肿瘤直径低于恶性病灶(P<0.05)。将病理诊断结果作为金标准，MRI联合乳腺钼靶X线诊断的灵敏度和特异度分别为91.67%和90.48%，均高于单纯MRI的75.00%和71.43%及单纯乳腺钼靶的66.67%和64.29%%，差异有统计学意义(P<0.05)。

结论

MRI联合乳腺钼靶X线在诊断乳腺导管原位癌时具有较高灵敏度和特异度，可为临床诊断及判断提供科学依据。

关键词: 癌，导管，乳腺, 磁共振成像, 诊断, 乳腺钼靶X线, 临床价值
Objective

To investigate the clinical value of MRI combined with mammography in the diagnosis of mammary ductal carcinoma in situ.

Methods

From February 2018 to February 2019, 90 patients with mammary ductal carcinoma in situ were enrolled in to present study. All the patients received both mammography and MRI examinations of the mammary gland, and the diagnostic value of combined examinations was evaluated. Statistical analysis were performed by using SPSS 22.0 software. Measurement data such as age and lesion diameter were expressed as (±s) and were examined by using t test. Pathological diagnosis was used as the gold standard to analyze the sensitivity and specificity of MRI and combined diagnosis. Count data were expressed as n(%), and were examined by using χ2 test, A P value <0.05 was considered as statistically significant.

Results

All of 90 patients with breast ductal carcinoma in situ had a single lesion, including 48 malignant lesions, and 42 benign lesions. There was no significant difference of age between patients with malignant lesions and benign lesions (P>0.05). The diameter of benign lesions was lower than that of malignant lesions, with significant difference (P<0.05). Taking the pathological diagnosis results as the gold standard, the sensitivity and specificity of MRI combined with mammography mammography targets were 91.67% and 90.48% respectively, which were higher than 75.00% and 71.43% of MRI alone and 66.67% and 64.29 of mammography alone respectively, with significant difference (P<0.05).

Conclusion

MRI combined with mammography has high sensitivity and specificity in the diagnosis of mammary ductal carcinoma in situ, which could provide scientific basis for clinical diagnosis and judgment.

Key words: Carcinoma, ductal, breast, Magnetic resonance imaging, Diagnosis, Mammography, Clinical value
表1 90例乳腺导管原位癌患者良恶性病灶的诊断结果(±s)
病灶性质 例 平均年龄(岁) 肿瘤直径(mm)
良性 42 39.54±5.14 11.52±0.93
恶性 48 38.96±5.67 22.96±1.25
t值 ? 0.506 48.672
P值 ? 0.614 0.000
表2 90例乳腺导管原位癌患者不同诊断方法的灵敏度及特异度的比较(例)
诊断方法 病理诊断 灵敏度 特异度
阳性 阴性
MRI联合乳腺钼靶 ? ? 91.67(44/48) 90.48(38/42)
? 阳性 44 4 - -
? 阴性 4 38 - -
单纯MRI检测 ? ? 75.00(36/48) 71.43(30/42)
? 阳性 36 12 - -
? 阴性 12 30 - -
单纯乳腺钼靶诊断 ? ? ? ?
? 阳性 32 16 66.67(32/48) 64.29(27/42)
? 阴性 15 27 ? ?
χ2值 ? ? 9.000 8.300
P值 ? ? 0.011 0.016
[1]
苏晓慧，林青，崔春晓，等．数字乳腺断层合成摄影、X线摄影及超声检查对乳腺非钙化导管原位癌的诊断价值[J]．中华放射学杂志，2018，52(1):15-19.
[2]
孙亚冬，李连方，刘山青，等．乳腺导管原位癌与导管原位癌伴微浸润的临床病理特点及预后对比分析[J]．中国实验诊断学，2019，23(5):818-822.
[3]
Killelea BK，Long JB，Dang WX，et al.Associations Between Sentinel Lymph Node Biopsy and Complications for Patients with Ductal Carcinoma In Situ[J]．Ann Surg Oncol，2018，25(6):1521-1529.
[4]
孙瑾，周锋盛，丁炎，等．剪切波弹性成像对穿刺活检诊断为乳腺导管内原位癌的患者升级为浸润性癌的预测价值[J]．中国肿瘤外科杂志，2019，11(3):172-177.
[5]
卢伟业，冯娅琴，陈志辉，等．超声造影评估乳腺导管原位癌术前病灶大小准确性的临床研究[J]．医学影像学杂志，2018，28(12):2055-2058,2077.
[6]
Ramzi S，Hyett EL，Wheal AS，et al.The case for the omission of axillary staging in invasive breast carcinoma that exhibits a predominant tubular growth pattern on preoperative biopsy[J]．Breast J，2018，24(4):493-500.
[7]
周涵霄，王宏桥．术前粗针活检低估的乳腺导管内原位癌的超声、钼靶及临床病理特征分析[J]．中国临床医学影像杂志，2019，30(4):257-260.
[8]
Hart V，Trentham-Dietz A，Berkman A，et al.The association between post-diagnosis health behaviors and long-term quality of life in survivors of ductal carcinoma in situ: a population-based longitudinal cohort study[J]．Qual Life Res，2018，27(5):1237-1247.
[9]
李晏，郑晓林，刘碧华，等．扩散加权成像对乳腺非肿块型浸润性导管癌及导管原位癌的量化分析及诊断价值[J]．中国CT和MRI杂志，2019，17(5):86-89.
[10]
Román M，Caicoya M，Espinàs J，et al.Clinical and histologic characteristics of breast cancers in women with previous pathologic diagnosis of benign breast disease in Spain[J]．Breast J，2018，24(4):509-518.
[11]
方友萍，吴俊兰，范梅花，等．超声检查对乳腺导管内原位癌诊断价值的临床研究[J]．浙江创伤外科，2019，24(2):374-375.
[12]
Hirth JM，Hatch SS，Lin YL，et al.Development and validation of algorithms to differentiate ductal carcinoma in situ from invasive breast cancer within administrative claims data[J]．Cancer，2018，124(13):2815-2823.
[13]
陈香梅，钟洁愉，孙德胜，等．超声对肉芽肿性小叶性乳腺炎与乳腺导管原位癌的鉴别诊断价值[J]．中国医学影像学杂志，2018，26(9):650-653.
[14]
Lee CW，Wu HK，Lai HW，et al.Preoperative clinicopathologic factors and breast magnetic resonance imaging features can predict ductal carcinoma in situ with invasive components[J]．Eur J Radiol，2016，85(4):780-789.
[15]
Commander LA，Ollila DW，O'Connor SM，et al.Ductal Carcinoma In Situ Simultaneously Involving the Breast and Epithelial Inclusions in an Ipsilateral Axillary Lymph Node[J]．Int J Surg Pathol，2018，26(6):564-568.
[16]
李婷婷，康春松，李慧展，等．剪切波弹性成像图像分型在乳腺肿瘤诊断中的价值[J]．中华肿瘤杂志，2019，41(7):540-545.
[17]
Patel GV，Van Sant EP，Taback B，et al.Patient Selection for Ductal Carcinoma In Situ Observation Trials: Are the Lesions Truly Low Risk[J]．Am J Roentgenol，2018，211(3):1-2.
[18]
李贤华，王兵．乳腺钼靶X线摄影检查联合磁共振成像诊断乳腺导管原位癌的有效性[J]．中国计划生育和妇产科，2018，10(2):64-66,71.
[1] 杨水华, 何桂丹, 覃桂灿, 梁蒙凤, 罗艳合, 李雪芹, 唐娟松. 胎儿孤立性完全型肺静脉异位引流的超声心动图特征及高分辨率血流联合时间-空间相关成像的应用[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1061-1067.
[2] 丁建民, 秦正义, 张翔, 周燕, 周洪雨, 王彦冬, 经翔. 超声造影与普美显磁共振成像对具有高危因素的≤3 cm肝结节进行LI-RADS分类诊断的前瞻性研究[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 930-938.
[3] 张莲莲, 惠品晶, 丁亚芳. 颈部血管超声在粥样硬化斑块易损性评估中的应用价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 816-821.
[4] 李培杰, 乔永杰, 张浩强, 曾健康, 谭飞, 李嘉欢, 王静, 周胜虎. 细菌培养阴性的假体周围感染诊治的最新进展[J]. 中华关节外科杂志(电子版), 2023, 17(06): 827-833.
[5] 彭旭, 邵永孚, 李铎, 邹瑞, 邢贞明. 结肠肝曲癌的诊断和外科治疗[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 108-110.
[6] 韩宇, 张武, 李安琪, 陈文颖, 谢斯栋. MRI肝脏影像报告和数据系统对非肝硬化乙肝患者肝细胞癌的诊断价值[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 669-673.
[7] 蓝冰, 王怀明, 王辉, 马波. 局部晚期结肠癌膀胱浸润的研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 505-511.
[8] 杨红杰, 张智春, 孙轶. 直肠癌淋巴结转移诊断研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 512-518.
[9] 顾睿祈, 方洪生, 蔡国响. 循环肿瘤DNA检测在结直肠癌诊治中的应用与进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 453-459.
[10] 钟广俊, 刘春华, 朱万森, 徐晓雷, 王兆军. MRI联合不同扫描序列在胃癌术前分期诊断及化疗效果和预后的评估[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 378-382.
[11] 吴凤芸, 滕鑫, 刘连娟. 高帧频超声造影与增强磁共振对不同直径原发性高分化肝细胞癌的诊断价值[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 404-408.
[12] 孙欣欣, 刘军, 陈超伍, 孙超. 超声内镜引导细针穿刺抽吸术在胰腺占位性病变中的应用[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 418-421.
[13] 袁媛, 赵良平, 刘智慧, 张丽萍, 谭丽梅, 閤梦琴. 子宫内膜癌组织中miR-25-3p、PTEN的表达及与病理参数的关系[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1016-1020.
[14] 李田, 徐洪, 刘和亮. 尘肺病的相关研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(08): 900-905.
[15] 周婷, 孙培培, 张二明, 安欣华, 向平超. 北京市石景山区40岁及以上居民慢性阻塞性肺疾病诊断现状调查[J]. 中华临床医师杂志(电子版), 2023, 17(07): 790-797.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号