近红外线扫描与彩色多普勒超声对乳腺肿块诊断的临床评价

目的 比较近红外线扫描与彩色多普勒超声对乳腺肿块的诊断价值。方法 对279例来院就诊的乳腺肿块患者行近红外线扫描和彩色超声多普勒检查后手术切除肿块病检,以病检结果为基础,对两种检查方法进行对比分析。结果 182例乳腺增生性肿块近红外线扫描的诊断符合率为94．0％,彩超为84．6％（P＜0．01）,前者明显优于后者,24例乳腺癌的诊断符合率前者为91．7％,后者为83．3％,虽有差异,但无统计学意义（P＞0．05）;对59例纤维腺瘤的诊断两者基本一致。两项检查相结合诊断符合率明显提高。结论 对乳腺增生性包块的诊断,近红外线扫描优于彩色多普勒超声;对乳腺癌的诊断两种检查方法难分优劣,但两种检查方法相结合可明显提高对乳腺肿块的诊断符合率。     

彩色多普勒超声、超声弹性成像与钼靶X线诊断乳腺疾病的价值

目的分析比较彩色多普勒超声、超声弹性成像与钼靶X线诊断乳腺疾病的价值。方法将2016-02—2017-02间在河南科技大学第一附属医院就诊的264例(288个病灶)乳腺疾病患者,分别使用彩色多普勒超声、超声弹性成像、钼靶X线和联合的方法进行诊断。以病理学检查结果为金标准,比较其诊断结果。结果 (1)病理诊断经288个病灶中有173例患者为良性,115例患者为恶性。(2)彩色多普勒超声的敏感性为84.3%(97/115),特异性为83.2%(144/173),准确性为83.7%(241/288)。钼靶X线诊断的敏感性为79.13%(91/115),特异性为76.3%(132/173),准确性为77.4%(223/288)。三者联合应用的敏感性为93.8%(107/114),特异性为93.0%(107/115),准确性为92.0%(265/288)。联合检查结果明显优于超声弹性成像、彩色多普勒及钼靶X线检查,差异有统计学意义(P0.05)。结论彩色多普勒超声、超声弹性成像与钼靶X线诊断乳腺疾病各有优势及不足。超声的敏感性比较好,超声弹性成像适用于检测弹性系数比较大的肿块,钼靶X线虽然对钙化有较高的敏感性,但是在诊断致密性乳腺及小乳房时敏感性比较差。三种方法联合检查,可有效提高乳腺疾病诊断的敏感性、特异性和准确性。     

近红外线扫描及彩色多普勒超声对乳腺癌的诊断价值比较

为了提高乳腺癌诊断的准确性，我们拟用病理结果为金标准以探讨近红外线扫描和彩色多普勒超声联合应用对乳腺癌的诊断价值。１资料和方法１．１临床资料本组病例均系我院门诊或住院的女性患者，年龄２０～６７岁。乳腺癌５１例，其中Ｔ０期３例，Ｔ１期２７例，Ｔ２期１８...     

彩色多普勒超声与钼靶摄片对乳腺癌的诊断价值

目的:评价彩色多普勒超声与钼靶X线联合应用对乳腺癌的诊断价值,以提高乳腺癌的检出率.方法:选择经手术病理证实的乳腺癌患者76例,对其超声、X线征象及其准确性进行统计学分析.结果:检出乳腺癌的准确性分别为:彩色多普勒超声80.3 ％(61/76),钼靶X线76.3％(58/76),两者比较差别无显著性:综合两者影像检查的准确性为93.4％(71/76),明显优于单一彩色多普勒或钼靶X线检查(P＜0.05).结论:彩色多普勒可作为首选与钼靶X线作用互补,综合两种影像检查能显著提高对早期乳腺癌的诊断率,在提高妇女的生命生活质量上,有其明显的实际意义.     

近红外线乳腺扫描仪在乳腺检查中的诊断价值

近红外线乳腺扫描仪近年来已被广泛用于乳腺检查。我院外科自 1991年 1月～ 1999年 3月 ,用近红外线乳腺扫描仪检查女性患者 46 75例 ,现报告如下。临床资料一、一般资料 :本组 46 75例 ,年龄 15～ 83岁 ,平均 38.5岁 ,病史最短 1d,最长2 3年 ,部分为来院体检者。二、检查方法 :患者在全暗室条件下取坐位 ,坐在转椅上 ,面对摄像头 ,上身裸露 ,双手后背 ,上身前倾 ,使乳房自然下垂 ,根据检查需要转动为正位或侧位。检查时尽量避免漏光 ,以免缺乏灰度对比。并且逐个象限检查 ,以免遗漏。病变部位靠近和正对摄像头 ,以减少失真。亮度选择在灰度…     

钼靶与超声对乳腺恶性肿瘤直接征象的对照研究

【摘要】 目的 评价X线钼靶、彩色多普勒超声单独运用与联合运用在诊断乳腺恶性肿瘤准确率、对肿块显示率的差异及临床价值。方法 回顾性分析564例乳腺恶性肿瘤患者的术前钼靶、超声及病理资料。评价564例乳腺恶性肿瘤患者的肿块的部位、形态、大小、边缘、密度或内部回声、后方回声,内部血流等影像学征象及其相关性,比较两种检查方法单独与联合运用对恶性肿瘤诊断率的差异。结果 564例乳腺恶性肿瘤,X线钼靶和彩色多普勒超声分别诊断422例和432例,两组联合诊断490例。其中浸润性导管癌439例,钼靶组诊断341例,超声组诊断356例,联合组诊断398例。结论 彩色多普勒超声与X线钼靶检查联合运用可显著提高浸润性导管癌的诊断符合率,但两者单独运用检出率无明显统计学差异。对于致密型乳腺,超声对乳腺恶性肿块的准确率大于X线钼靶。对于脂肪型背景乳腺,钼靶对乳腺恶性肿块的准确率大于彩色多普勒超声。     

近红外乳腺扫描影像与乳腺增生病辨证分型关系探讨

目的 探讨影像诊断技术与中医辨证分型的关系，使用药更有针对性、合理性。方法 采用近红外乳腺扫描影像技术对820例乳腺增生病患者进行扫描检查，同时进行护理指导。结果 820例患者检查顺利，不同证型的乳腺增生病其近红外乳腺影像各有差异。结论 近红外乳腺扫描检查敏感性高、直观、无创、操作方便，检查中良好的护理有利于检查顺利进行。     

计算机近红外光扫描与钼靶摄片诊断乳腺肿瘤的对比研究

计算机近红外光扫描与钼靶摄片诊断乳腺肿瘤的对比研究孙华文，钟翠云，杨清，富成谧计算机近红外光诊断乳腺疾病是本世纪八十年代以来在国内外广泛应用的一项新技术。为评价其临床应用价值，我们对１９９２年７月～１９９５年１１月在本院手术治疗的１１２例乳腺肿瘤患者...     

彩色多普勒超声诊断乳腺肿瘤

目的分析乳腺良恶性肿瘤的二维及彩色多普勒超声表现,评价彩色多普勒超声在诊断乳腺癌中的应用价值。方法对674例乳腺肿瘤患者（恶性327例,良性347例）进行二维超声及彩色多普勒超声检查,以二维超声观察肿块的大小、形态、边界、内部回声等,以彩色多普勒超声观察肿块内部血流信号,测量血流峰值速度（PSV）和阻力指数（RI）等。结果674例中超声发现肿块671例,肿块大小0．50cm×0．41cm～5．42cm×4．10cm。恶性肿瘤肿块纵横径比≥1．0占69．11％（226／327）,肿块边界不整齐,呈“锯齿”状或“蟹足”状约占81．35％（266／327）,肿块内部沙粒样钙化点占61．47％（201／327）;彩色多普勒对血流信号的显示率为92．97％（304／327）,PSV为15．34～39．76cm／s,RI为0．65～0．98,RI≥0．70占91．61％（262／286）。良、恶性肿瘤在肿块纵横径比、肿块边界、沙粒样钙化及血流信号、PSV、RI等方面差异均有统计学意义（P〈0．01）。结论二维超声结合血流信号、PSV及RI值可显著提高乳腺良、恶性肿瘤的诊断与鉴别,彩色多普勒超声在乳腺癌的诊断中具有重要作用。     

近红外乳腺扫描影像与乳腺增生病辨证分型关系探讨

目的探讨影像诊断技术与中医辨证分型的关系,使用药更有针对性、合理性.方法采用近红外乳腺扫描影像技术对820例乳腺增生病患者进行扫描检查,同时进行护理指导.结果 820例患者检查顺利,不同证型的乳腺增生病其近红外乳腺影像各有差异.结论近红外乳腺扫描检查敏感性高、直观、无创、操作方便,检查中良好的护理有利于检查顺利进行.     

X线钼靶摄影与超声诊断乳腺微钙化灶的对比研究

目的：比较X线钼靶摄影与超声在乳腺微钙化灶诊断中的价值。方法：收集伴随微钙化灶（经X线钼靶摄影确诊）的乳腺良性、恶性疾病患者117例,分析超声对乳腺微钙化的检出率;比较X线钼靶摄影与超声检查对乳腺微钙化灶病例诊断的敏感性、特异性及准确性。结果：乳腺微钙化的超声检出率为66.7%,其中乳腺恶性病灶的微钙化超声检出率为87.5%,乳腺良性病变的微钙化灶超声检出率为33.3%,超声诊断乳腺微钙化灶病例的敏感性、特异性和准确性分别为69.4%、86.7%和76.1%,X线钼靶摄影分别为75.0%、73.3%、74.3%,两者联合应用为90.2%、91.1%、90.5%。结论：X线钼靶摄影与超声相比,前者具有较高的敏感性,后者具有较高的特异性,而两者联合应用可提高对乳腺微钙化灶病例诊断的准确率,对于乳腺癌的早期诊断具有较高的临床实用价值。     

乳腺叶状肿瘤X射线表现与临床及病理对照分析

目的探讨乳腺叶状肿瘤X射线表现与其临床及病理改变的相关性,以确定其不同特征及其病理组织学基础,达到提高临床诊断率及指导治疗的目的。方法分析我院2010年1月至2013年1月期间经手术病理证实的28例乳腺叶状肿瘤患者的临床及X射线影像学资料,观察其影像表现并与病理结果进行对照分析。结果 28例乳腺叶状肿瘤中,良性17例,交界性8例,恶性3例。X射线摄片显示瘤体26例,另外2例仅显示单侧乳腺非对称致密影,其中23例均归为BI-RADS 4类或4类以上。肿瘤直径约2.8～10.2 cm。以3 cm为界,肿瘤直径≥3 cm者与〈3 cm者相比,出现良性与非良性叶状肿瘤（交界性及恶性）的概率差异无统计学意义（Ρ〉0.05）。良性和非良性叶状肿瘤的分叶状况差异也无统计学意义（Ρ〉0.05）,然而非良性叶状肿瘤多表现为边界模糊肿块（Ρ〈0.05）。2例良性叶状肿瘤见异常血管,1例良性叶状肿瘤见钙化,良性叶状肿瘤（8/17）和非良性叶状肿瘤（2/11）出现＂透明晕＂征象比较差异无统计学意义（Ρ〉0.05）。结论乳腺叶状肿瘤的一些典型X射线表现结合临床改变有利于早期发现病变,但良性与非良性叶状肿瘤的影像学表现无明显差异,该病的确认及组织学分型必须依靠病理学检查。     

三算子及血氧功能成像系统在乳腺癌诊断中的应用

目的 探讨三算子及血氧功能成像系统在乳腺癌诊断中的应用价值。方法 2011年11月～2013年8月对我科收治的73例疑似乳腺癌行超声、钼靶和乳腺三算子及血氧成像系统检查,通过与术后病理对比,比较3种检测方法在诊断乳腺癌上的准确性。结果 超声、钼靶与三算子及血氧功能成像的阳性预测值分别为94.3％（50／53）、94。8％（55／58）、90.8％（59／65）;误诊率分别为50.O％（3／6）、50.0％（3／6）、100.0％（6／6）;漏诊率分别为25.4％（17／67）、17.9％（12／67）、11.9％（8／67）;准确率分别为72.6％（53／73）、79.4％（58／73）、80.8％（59／73）。3种检测方法的阳性预测值、误诊率、准确率无统计学差异（P〉0.05）,三算子及血氧功能成像的漏诊率显著低于超声（Z=-1.988,P：0.047）。结论 三算子及血氧功能成像对乳腺癌诊断的准确率不逊于超声和钼靶,在乳腺癌的诊断中有较大的应用价值。     

Effect of Obesity on Presentation of Breast Cancer

Background Obesity has been shown to be associated with reduced survival in patients with invasive breast cancer (IBC), although the mechanisms for this finding are unclear. The objective of this study was to examine the effect of obesity on the presentation and pathologic staging of IBC. Methods From February 15, 2002, to February 15, 2004, all patients undergoing surgery for primary IBC at two institutions were enrolled in a prospective cohort study. National Institutes of Health criteria were used to categorize patients: normal or underweight (NW; body mass index <25 kg/m²), overweight (OW; body mass index 25–29.9 kg/m²), and obese or severely obese (OB; body mass index ≥30 kg/m²). Presentation and pathologic factors were then compared among groups. Results The study cohort consisted of 519 patients; 166 (32%) were NW, 177 (34%) were OW, and 176 (34%) were OB. OW (46%) and OB (39%) patients were more likely to be diagnosed with IBC via screening mammography compared with NW (31%) patients (P = .01), although no differences were found between groups with respect to previous use of screening mammography. Aggressive pathologic features, including lymph node metastases, advanced tumor-node-metastasis stage, and grade were found more commonly among OB patients. Conclusions OW and OB patients were more likely to receive a diagnosis via screening mammography, thus suggesting that mammography may play a more important role in OW and OB patients. Despite this, OB patients presented with larger, more advanced tumors; this may help to explain obesity-associated survival differences in IBC patients. This is important information given the prevalence of obesity in North America.     

Breast Cancer Detection With 99m-Tc-Sestamibi Scintigraphy, Mammography, and Fine-Needle Aspiration Cytology: Comparative Study in 64 Surgically Treated Patients

Background: In breast cancer, mammography (MG) fails to reveal malignancy in 10% to 15% of patients, and its sensitivity is limited by dense breast tissue. The aim of this study was to evaluate the usefulness of 99m-Tc-sestamibi scintimammography (SMM) in conjunction with MG and fine needle aspiration (FNA) cytology in the detection of low-stage breast cancer.Methods: A total of 64 women (median age 58 years, range 32–86 years), 53 (82.8%) with palpable and 11 (17.2%) with nonpalpable breast mass, underwent SMM; 61 patients had MG and 62 underwent FNA cytology. At histological examination, breast cancer was found in 59 (92.2%) of the women (pTis = 2, pT1a = 2, pT1b = 13, pT1c = 20, pT2 = 22).Results: Of the 61 patients who had MG, 45 (73.8%) showed signs of cancer or abnormalities. Of the 62 patients who had FNA cytology, 55 (88.7%) showed malignancy. In 5 (8.1%) patients, atypical ductal hyperplasia or complex sclerosing lesions were found. MG, SMM, and FNA cytology were 80.4%, 78.0%, and 96.5% sensitive, respectively, and their positive predictive value was 97.8%, 100%, and 100%, respectively. In all patients, cancer was at least detected by one of these three techniques.Conclusions: In women with suspicious MG or abnormal FNA cytology that required further investigations, SMM may be helpful in surgical planning and should be considered in most patients before biopsy as an additional noninvasive procedure.Presented at the 52 Annual Cancer Symposium of The Society of Surgical Oncology, Orlando, Florida, March 4–7, 1999.     

Effectiveness of Breast-Specific Gamma Imaging (BSGI) for Breast Cancer in Korea: A Comparative Study

Abstract: Despite the fact that mammography has been the golden standard in breast cancer detection for several decades, its sensitivity decreases for women with dense breast tissue, which happens to be common in Korea. As an alternative, breast ultrasonography can be effective diagnostic modalities that complement the defect of mammography. Recently, breast‐specific gamma imaging (BSGI) has been introduced as a new diagnostic modality for breast cancer. This study was designed to analyze the effectiveness of BSGI in particular. In a retrospective study, 471 patients underwent BSGI, breast ultrasonography, and mammography simultaneously during the period between February 2009 and March 2010. The indications of BSGI were as follows: (a) patient who was diagnosed with malignancy prior to surgery, (b) patient who is under follow up after cancer surgery, (c) patient with lesions which cannot be evaluated by breast ultrasonography or mammography, (d) patient with multiple benign lesions, and (e) patient with suspicious lesion who refuses biopsy. Among these patients, 121 patients underwent biopsy, whereas others were followed up with imaging studies. We compared the BSGI results with those of mammography, breast ultrasonography, and pathology. The mean age of the patients was 49.63 ± 10.43 years. There were 107 patients with 110 malignant lesions and 364 patients with benign lesions. Total 474 lesions were evaluated. The sensitivities of BSGI, mammography, and breast ultrasonography were 94.45%, 93.64%, and 98.18%, respectively, whereas the specificities of BSGI, mammography, and breast ultrasonography were 90.93%, 90.66%, and 87.09%, respectively. The sensitivity and specificity of BSGI for axillary lymph node (LN) status were 44.7 4% and 87.88%, respectively. BSGI is a good complementary imaging modality with high sensitivity and high specificity for breast cancer detection. However, it has low efficacy for the evaluation for axillary LN status.     

彩色多普勒超声与全数字化乳腺摄影对乳腺良恶性病变的诊断价值

目的探讨彩色多普勒超声(CDU)与全数字化乳腺摄影(FFDM)对乳腺良恶性病变诊断与鉴别诊断的价值。方法回顾性分析经手术和病理证实的107例乳腺良性病变和100例乳腺癌患者的临床资料。将患者术前CDU和FFDM检查结果与最后诊断对比,评价两项检查方法各自的准确性及两项联合的诊断效能。结果所有患者术前均行CDU和FFDM检查,CDU、FFDM及两项联合对乳腺癌诊断的敏感性、特异性分别为88%和82.24%;89%和75.7%;97%和88.78%。经ROC分析,对乳腺良恶性病变诊断的整体准确性依次为两项联合>CDU>FFDM。CDU,FFDM对乳腺癌肿块影显示率分别为95%和70%,两者差异有统计学意义(P<0.01)。对绝经前、后乳腺癌检出率,CDU分别为9 3.5%和8 3.3%(P>0.0 5),FFDM分别为8 0.4%和9 6.3%(P<0.0 5)。绝经前乳腺癌检出率CDU与FFDM无明显差异(P>0.05),绝经后乳腺癌检出率FFDM高于CDU(P<0.05)。结论 CDU检查对肿块敏感性高,FFDM对绝经后乳腺癌的检出率高;两者联用可提高对乳腺良恶性病变诊断的整体准确性,降低误诊率和漏诊率。     

Comparative Study of Breast Implant Rupture Using Mammography,Sonography, and Magnetic Resonance Imaging: Correlation with Surgical Findings

Abstract: Purpose of this study was to evaluate the accuracy of mammography, ultrasonography, and magnetic resonance imaging (MRI), in the detection of breast implant rupture and to make a correlation with findings at explantation. The study population consisted of 63 women with 82 implants, undergoing surgical explantation. Implant rupture status was blindly determined obtaining diagnosis of rupture, possible rupture, or intact implant. Strictly predetermined rupture criteria were applied and compared with findings at surgery, which were considered the gold standard. False‐positives and false‐negatives were retrospectively evaluated to identify pitfalls in the investigation. All associations between imaging signs and surgical findings were evaluated by using chi‐square test. The respective sensitivity and specificity of investigations are reported. Our experience suggests that MRI is the more accurate method for identification of breast implant rupture, even if it should be performed following the diagnostic algorithm proposed.     

99锝m-tetrofosmin乳腺扫描鉴别乳腺包块性质的临床研究

目的探讨99锝m-tetrofosmin乳腺扫描在鉴别可扪及的乳腺包块良恶性质方面的价值.方法 2000年6月至2002年1月在我院临床发现乳腺包块的104例患者接受了99锝m-tetrofosmin乳腺扫描.检查时先经病变对侧肘静脉注射740 MBq显像剂,注射后5、10及20 min 分别采集前位和侧位图像.距阵256×256,每帧记数1～1.5 M,将99锝m-tetrofosmin在乳房局部浓聚视为亲肿瘤显像阳性.全部病例以术后病理结果为金标准,以四格表进行评价分析.结果 99锝m-tetrofosmin在对可扪及的乳腺包块性质进行鉴别诊断时,特异性为84%,敏感性为87%,准确性为86%,阳性预测值为85%,阴性预测值为86%.结论 99锝m-tetrofosmin在对可扪及的乳腺包块进行良恶性质的鉴别时,不失为一种较为准确的方法.