钼靶X-线检查未见明确肿块和超声影像的对比分析

目的对比分析钼靶照片未见明确肿块的乳腺癌的X-线和超声图像特点,探讨X-线和超声检查联合应用对提高此类乳腺癌诊断符合率的价值。方法对2001年12月~2003年12月36例(共38个病灶)钼靶未见明确肿块的乳腺癌女性患者进行回顾性分析。结果X-线表现有单纯致密影12个,单纯钙化8个,致密影+钙化5个,致密影+皮肤增厚+乳头内陷3个,钙化+血管影增多2个,8个病灶未见任何征象而漏诊。与病理结果对照,诊断准确率为55.3%,敏感性为78.9%,特异性为81.6%。钙化的显示率为39.5%。超声表现有单纯肿块29个,肿块+钙化5个,乳腺增生改变1个,3个病灶未见任何征象而漏诊。与病理结果对照,诊断准确率为81.6%,敏感性为92.1%,特异性为89.5%,肿块显示率为89.5%,钙化的显示率为13.2%。钼靶和超声联合应用的诊断准确率为89.5%,敏感性为100%,特异性为89.5%,钙化的显示率为42.1%。结论超声检查对乳腺癌肿块的显示优于钼靶检查,两者联合应用,有助于钼靶未见明确肿块的乳腺癌的早期发现和正确诊断。

Ultrasonic Diagnosis of Mammary Cancer Without Visible Lumps in Molybdenum Target:Comparison With X-ray

Objective To contrast and analyze the X-ray and ultrasonic image features of mammary cancers without visible lumps in molybdenum target and to investigate the value of elevating the diagnostic accordance rate in this kind of mammary cancers.Methods In 36 female with 38 focuses of mammary cancers without visible lumps in molybdenum target from December,2001 to December,2003 were retrospectively analyzed.Results The X-ray appearances were pure pykno-shadow in 12 pieces,pure calcification in 8,pykno-shadow + calcification in 5,pykno-shadow + pachyderma + nipple invagination in 3 and calcification + multiple vaso-shadows in 2.Eight focuses without any signs were miss diagnosed.Comparing with the pathological results,the diagnostic accordance rate,the sensitivity,the specificity and the displayed rate of calcification were 55.3%,78.9%,81.6% and 39.5% respectively.The ultrasonic appearances were:pure lump in 29 pieces,lump + calcification in 5,hyperplasia of mammary glands in 1.Three focuses without any signs were miss diagnosed.Comparing with the pathological results,the ultrasonic diagnostic accordance rate,the sensitivity,the specificity,the displayed rate of lumps the were 81.6%,92.1%,89.5%,89.5% respectively and the displayed rate of calcification wa 13.2%.The diagnostic accordance rate of the combination of X-ray and ultrasound,the sensitivity,the specificity and the displayed rate of calcification were 89.5%,100%,89.5% and 42.1% respectively.Conclusions Sonography has an advantage in displaying the breast tumor.The application of the combination of X-ray and ultrasound help early discover and correctly diagnose mammary cancer without visible lump in molybdenum target.