超声与钼靶摄影诊断乳腺导管内癌的对照研究

目的评价超声、钼靶摄影以及二者综合对乳腺导管内癌的诊断准确性。 方法分析经病理证实的83例乳腺导管内癌的钼靶摄影和超声表现，并比较其诊断准确性。 结果（1）超声表现腺体内低回声实性病变52例（62．7％），导管内实性结节16例（19．3％），囊性病变或乳腺导管扩张7例（8．4％），阴性8例（9．6％）；（2）钼靶摄影表现簇状微小钙化53例（63．9％），软组织结节或局部密度增高50例（60．2％），未发现明确病变者9例（10．8％）；（3）分类比较超声、钼靶摄影和二者综合分类为可能恶性者分别为47例、53例、67例，2种方法准确率差异无统计学意义（56．6％和63．9％，P=0．169）；综合2种方法后诊断准确率高于钼靶摄影（80．7％和63．9％，P〈0．001）。 结论超声和钼靶摄影诊断导管内癌的准确率较低。综合应用2种检查方法可提高诊断准确率。

Ultrasonographic and Mammographic Diagnoses of Breast Ductal Carcinoma in Situ

Objective To evaluate the accuracy of ultrasound,mammography and combination of both modalities in the diagnosis of breast ductal carcinoma in situ (DCIS).Methods The mammographic and sonographic appearances of breast DCIS in 83 patients were analyzed,and the diagnostic accuracies of both modalities and combination of them were compared.Results 1.Ultrasound found hypoechoic solid lesion in 52 cases (62.7%),intraductal nodular lesions in 16 cases (19.3%)and cysts or ductal dilation in 7 cases (8.4%),and a negative finding in 8 cases (9.6%),2.On mammography,clustered micro-calcifications were found in 53 cases (63.9%),nodular lesion or local increased density in 50 cases (60.2%)and no lesion in 9 cases (10.8%).3.The lesion in 47,53,and 67 cases was diagnosed as malignancy by ultrasound,mammography,and combination of them,respectively.The accuracy of ultrasound and mammography was not statistically different (56.6% vs.63.9%,P=0.169)and the accuracy of combination of both modalities was higher than that of simple mammography (80.7% vs.63.9%,P<0.001).Conclusions Ultrasound and mammography have a similar low accuracy in the diagnosis of DCIS,but the diagnostic accuracy can be improved by combination of both modalities.