High-frequency ultrasound combined with magnetic resonance imaging can improve the early diagnostic value of breast cancer
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摘要:
目的分析高频超声联合MRI在乳腺癌早期诊断的价值。 方法回顾2018年1月~2019年11月因乳腺肿块于我院诊治的85例患者，所有患者均接受高频超声和MRI检查，以病理结果为标准，观察高频超声、MRI检查以及二者联合检测的阳性检出率，比较高频超声、MRI检查以及二者联合诊断乳腺癌及其分期的价值。 结果85例乳腺肿块患者进行病理学检查，共发现病灶107个，其中良性59个，恶性48个；高频超声检查显示，40个病灶诊断为乳腺癌，其中8个病灶漏诊；45个病灶诊断为良性肿块，其中14个病灶误诊；MRI检查显示，46个病灶诊断为乳腺癌，其中2个病灶漏诊；53个病灶诊断为良性肿块，其中6个病灶误诊；高频超声联合MRI检查显示，47个病灶诊断为乳腺癌，其中1个病灶漏诊；56个病灶诊断为良性肿块，其中3个病灶误诊；高频超声联合MRI诊断乳腺癌的准确性、敏感度、特异度、阳性预测值以及阴性预测值高于高频超声（P < 0.05），MRI诊断乳腺癌的准确性高于高频超声（P < 0.05），敏感度、特异度、阳性预测值以及阴性预测值与MRI比较，差异无统计学意义（P>0.05）；高频超声联合MRI诊断不同分期乳腺癌优于高频超声和MRI，但差异无统计学意义（P>0.05）。 结论高频超声和MRI均可有效诊断乳腺癌，二者联合应用可提高对乳腺癌早期诊断及分期的诊断价值，为临床治疗提供有效帮助。 Abstract:ObjectiveTo analyze the application value of high-frequency ultrasound combined with magnetic resonance imaging (MRI) in the early diagnosis of breast cancer. MethodsA retrospective study was performed on 85 patients diagnosed and treated in our hospital due to breast masses from January 2018 to November 2019. All patients underwent high-frequency ultrasound and MRI. Based on pathological results, the positive detection rates of high-frequency ultrasound, MRI and the combination of the two were observed. The value of high-frequency ultrasound, MRI and the combination of the two in the diagnosis of breast cancer and its staging were compared. ResultsThe pathological examination of 85 patients with breast masses revealed a total of 107 lesions, including 59 benign lesions and 48 malignant lesions. High-frequency ultrasound showed that 40 lesions were diagnosed as breast cancer with 8 lesions of missed diagnosis, and 45 lesions were diagnosed as benign masses with 14 lesions of misdiagnosis. MRI showed that 46 lesions were diagnosed as breast cancer with 2 lesions of missed diagnosis, and 53 lesions were diagnosed as benign masses with 6 lesions of misdiagnosis. High-frequency ultrasound combined with MRI showed that 47 lesions were diagnosed as breast cancer with 1 lesion of missed diagnosis, and 56 lesions were diagnosed as benign masses with 3 lesions of misdiagnosis. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of high-frequency ultrasound combined with MRI in the diagnosis of breast cancer were higher than those of high-frequency ultrasound (P < 0.05). The accuracy of MRI in the diagnosis of breast cancer was higher than that of high-frequency ultrasound (P < 0.05). The differences of the sensitivity, specificity, positive predictive value and negative predictive value compared with those of MRI were not significant (P>0.05). High-frequency ultrasound combined with MRI was superior to high-frequency ultrasound or MRI in the diagnosis of breast cancer with different stages (P>0.05). ConclusionBoth high-frequency ultrasound and MRI can effectively diagnose breast cancer. The combined application of the two can improve the diagnostic value of early diagnosis and staging of breast cancer, and provide effective help for clinical treatment. -
Key words:
- high-frequency ultrasound /
- magnetic resonance imaging /
- breast cancer /
- diagnosis /
- staging
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图 2 高频超声显示左乳实性低回声肿物，形态不规则，边缘不清晰，呈现“毛刺状”
Figure 2. High-frequency ultrasound showed a solid hypoechoic mass in the left breast, with irregular shape and unclear edges, showing a "burr-like" shape.
图 3 MRI显示左侧乳腺肿块合并左乳内淋巴结结节，肿块形态不规则，边缘表现为蟹足状改变，T1WI表现低信号，增强扫描可见早期强化
Figure 3. MRI showed the left breast mass with left intramammary lymph node nodules, irregular mass. The edges showed crab-shaped changes, the T1WI showed low signal and the enhanced scan showed early enhancement.
表 1 高频超声和MRI检查诊断乳腺癌结果与病理结果比较
Table 1. Comparison of results of high-frequency ultrasound and MRI diagnosis of breast cancer with pathological results (n)
检查方法 病理结果 合计 + - 高频超声 + 40 14 54 - 8 45 53 MRI + 45 6 51 - 3 53 56 高频超声联合MRI + 47 3 50 - 1 56 57 合计 48 59 107 
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表 2 高频超声和MRI检查诊断乳腺癌结果比较
Table 2. Comparison of results of high-frequency ultrasound and MRI in the diagnosis of breast cancer (%)
检查方法 准确性 敏感度 特异度 阳性预测值 阴性预测值 高频超声 79.44 83.33 76.27 74.07 84.91 MRI 91.59 93.75 89.83 88.24 94.64 高频超声联合MRI 96.26 97.92 94.92 94.00 98.25 χ2 16.611 7.091 9.695 8.725 7.729 P 0.000 0.042 0.008 0.013 0.028
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表 3 高频超声和MRI检查诊断不同分期乳腺癌结果比较
Table 3. Comparison of results of high-frequency ultrasound and MRI in the diagnosis of breast cancer in different stages (n)
检查方法 分期 病理结果 合计 Ⅰ Ⅱ Ⅲ Ⅳ 高频超声 Ⅰ 2 2 0 0 4 Ⅱ 1 23 2 1 27 Ⅲ 1 0 10 1 12 Ⅳ 0 0 1 4 5 MRI Ⅰ 3 1 0 0 4 Ⅱ 1 24 1 1 27 Ⅲ 0 0 11 1 12 Ⅳ 0 0 1 4 5 高频超声联合MRI Ⅰ 3 0 0 0 3 Ⅱ 1 25 0 0 26 Ⅲ 0 0 12 1 13 Ⅳ 0 0 1 5 6 合计 4 25 13 6 48
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