高频超声与X线钼靶联合应用对早期乳腺癌的诊断价值

目的探讨高频超声与X线钼靶联合应用对早期乳腺癌的诊断价值。方法分别采用高频超声与X线钼靶两种方法检查61例乳腺小肿块,观测病变大小、内部回声及血流等,全部病例经穿刺活检或手术病理证实。结果高频超声检查的敏感性、特异性、准确性、阳性预测值、阴性预测值及假阳性率、假阴性率分别是82.61%、53.33%、75.41%、84.44%、50.00%及46.67%、17.34%;钼靶分别是89.13%、60.00%、81.97%、87.23%、64.29%及40.00%、10.87%,两种方法比较无显著性差异。二者联合应用的各指标分别是95.65%、73.33%、90.16%、91.67%、84.12%及26.67%、4.35%,准确性比单一方法有明显提高,而假阳性率和假阴性率显著降低。结论两种方法联合应用能提高早期乳腺癌诊断的敏感性及准确性,降低误诊率和漏诊率,具有较高的临床实用价值。     

超声与钼靶及二者联合应用诊断早期乳腺癌的临床价值

目的 探讨超声、钼靶摄片及二者联合应用对乳腺肿瘤的诊断价值.方法 对120例乳腺肿块病例进行回顾性分析,对彩色多普勒超声、乳腺钼靶摄片及二者联合应用与病理诊断符合率进行统计学分析.结果 超声检查、钼靶摄片、二者联合应用诊断乳腺癌的准确性分别为70.83%、70.83%、90.00%,敏感性分别为83.58%、85.08%、97.01%;特异性分别为54.72%、52.83%、81.13%,阳性预测值分别为70.00%、69.51%、86.67%,阴性预测值分别为72.50%、73.68%、95.56%,假阳性率分别为45.28%、47.17%、18.87%,假阴性率分别为16.42%、14.93%、2.99%.超声检查与钼靶摄片比较差异均无统计学意义(P均>0.05);二者联合应用的各检测值与彩色多普勒超声、乳腺钼靶摄片单一方法比较,差异均有统计学意义(P均<0.05).且二者联合应用与病理诊断的符合率亦比单一方法诊断的符合率高.结论 两种方法联合应用能提高早期乳腺癌的准确性、敏感性及特异性,具有较高的临床价值.     

高频超声联合钼靶X线摄影诊断乳腺肿块价值

目的探讨高频超声联合乳腺数字化钼靶X线摄影在乳腺肿块诊断中的价值。方法乳腺肿块患者116例(121个肿块),均于术前7d行乳腺高频超声、钼靶X线摄影检查,与手术或超声引导下穿刺活检组织病理结果进行对照,比较高频超声、钼靶X线单独及联合诊断乳腺肿块的准确性、敏感性、特异性。结果组织病理诊断良性肿块37个,恶性肿块84个;高频超声诊断良性肿块42个,恶性肿块79个;钼靶X线诊断良性肿块64个,恶性肿块57个;高频超声联合钼靶X线诊断良性肿块46个,恶性肿块75个;以组织病理结果为标准,高频超声诊断乳腺肿块的准确性为62.8%、敏感性为70.2%、特异性为45.9%、阳性预测值为74.7%、阴性预测值为40.5%、假阳性率为54.1%、假阴性率为29.8%,钼靶X线分别为56.2%、52.4%、64.9%、77.2%、37.5%、35.1%、52.4%,高频超声联合钼靶X线分别为76.0%、77.4%、73.0%、86.7%、58.7%、27.0%、22.6%;高频超声联合钼靶X线诊断乳腺肿块的准确性、敏感性、阳性预测值和阴性预测值高于高频超声、钼靶X线,特异性高于高频超声、假阳性率低于高频超声,差异均有统计学意义(P0.05)。结论高频超声和钼靶X线在乳腺肿块诊断中各具优势,二者联合可优劣互补,提高诊断准确率。     

乳腺超声、钼靶和增强磁共振的诊断效能比较

目的：探讨乳腺病变的超声、钼靶和增强磁共振检查3种最常用影像学检查方法的诊断效能。方法：收集术前完成乳腺超声、乳腺钼靶和乳腺增强磁共振检查的378个乳腺病灶。对比分析超声、钼靶、增强磁共振检查的准确性、特异性、敏感性、阳性预测值和阴性预测值以及BI-RADS分级后各级的阳性预测值和阴性预测值。采用卡方检验计算P值,P＜0.05为具有显著差异。结果：超声、钼靶和增强磁共振的敏感性、特异性和准确性分别为92.81%、89.52%、90.83%,66.67%、58.20%、60.98%和98.55%、78.50%、86.43%。超声和增强磁共振的敏感性、特异性和准确性显著高于钼靶。结论：增强磁共振检查的敏感性最高,超声检查的特异性最高,两者对恶性和良性病灶的诊断各有其优势。而钼靶对恶性病灶的预测具有一定价值。     

血清相关肿瘤标志物检测联合钼靶CR摄影及高频超声成像在临床触诊阴性乳腺癌诊断中的应用

目的:分析钼靶CR摄影、高频超声成像和血清肿瘤标志物检测单独及联合检查在触诊阴性乳腺癌诊断中的应用价值。方法:收集经过病理明确诊断的临床触诊阴性乳腺癌65例,均完成钼靶CR摄影、高频超声成像及血清肿瘤标志物检测三种检查,分别计算三种检查方法单独及联合诊断的敏感性、特异性及准确性,分析各种不同检查方法及联合检查方法之间的差别及不同腺体类型乳腺之间钼靶CR摄影诊断结果的差异。结果:钼靶CR摄影与超声联合检查的诊断敏感性、特异性和准确性分别为91.87%、85.43%和88.71%,两者的单独检查结果分别为80.15%、87.53%、83.26%和81.18%、88.95%、84.15%,三者联合检查的诊断敏感性、特异性和准确性分别为78.26%、76.35%和89.27%。结论:钼靶CR摄影与超声联合诊断临床触诊阴性乳腺癌的准确性明显提高,血清肿瘤标志物检测对于早期乳腺癌的诊断意义低于另外两种检查方法。     

乳腺钼靶联合超声在乳腺癌早期诊断中的价值

目的探讨在乳腺癌早期诊断中应用乳腺钼靶联合超声检查的价值。方法选择2017年3月～2019年7月我院接收的疑似早期乳腺癌患者96例,均为女性。均进行乳腺钼靶检查、超声检查,以病理检查结果为诊断金标准,比较单项检查与联合检查的的准确率、灵敏度、特异度、阳性预测值、阴性预测值。结果 96例疑似早期乳腺癌患者中,确诊70例;与单项检测相比,乳腺钼靶联合超声检查的准确性、灵敏度、特异度、阳性预测值、阴性预测值较高,差异有统计学意义(P0.05)。结论在乳腺癌早期诊断中应用乳腺钼靶联合超声检查准确率较高,可降低漏诊、误诊率,对早期疾病诊断、临床治疗、预后评估具有重要意义。     

MRI联合钼靶X线摄影在乳腺疾病中的诊断价值

目的:探讨MRI联合钼靶X线摄影在乳腺疾病中的诊断价值。方法:以我院2020年7月至2021年2月期间收治的125例乳腺疾病患者为研究对象,所有患者均行乳腺MRI及乳腺钼靶X线摄影检查,最终以病理结果为诊断依据,分析不同检查方法的诊断结果。结果:在125例受检者中,病理结果确诊乳腺癌90例,其他良性病变35例;MRI阳性检出率为93.33%,钼靶X线阳性检出率为88.89%,联合诊断检阳性检出率为98.89%,组间比较存在统计学差异(P<0.05);钼靶X线的诊断敏感性、特异性、准确性、阳性预测值分别为77.78%、71.43%、76.00%、87.50%;MRI的诊断敏感性、特异性、准确性及阳性预测值分别为81.11%、68.57%、77.60%、86.90%;联合诊断的诊断敏感性、特异性、准确性及阳性预测值分别为96.67%、94.29%、96.00%、97.75%;组间比较存在统计学差异(P<0.05)。结论:MRI联合钼靶X线摄影可有效提高乳腺疾病的阳性检查率及诊断效能,可为临床确立治疗方案提供有力的参考依据,值得在乳腺疾病诊断中应用推广。     

超声联合弹性成像与常规超声、钼靶X线摄影对触诊阴性乳腺病灶诊断价值的对比分析

目的分析常规超声、钼靶X线摄影、超声弹性成像和常规超声+超声弹性成像对触诊阴性乳腺病灶的诊断价值,以提高早期乳腺癌的检出率。方法对触诊阴性乳腺病灶的238例患者(266个肿块,其中恶性79个肿块、良性187个肿块)的术前常规超声、钼靶X线摄影、超声弹性成像和超声+超声弹性成像的诊断结果进行分析,并与术后病理结果作对照。结果钼靶X线摄影的敏感性、特异性和准确性分别为79.8%、75.9%和77.1%;常规超声的敏感性、特异性和准确性分别为77.2%、86.1%和83.5%;超声弹性成像的敏感性、特异性和准确性分别为82.3%、87.2%和85.7%;超声+弹性成像敏感性、特异性和准确性分别为92.4%、93%和92.9%。敏感性:超声+超声弹性成像均高于常规超声、钼靶X线摄影和超声弹性成像(均P<0.05);常规超声、钼靶X线摄影和超声弹性成像的敏感性比较差异无统计学意义(均P>0.05)。特异性及准确性:超声、超声弹性成像均高于钼靶X线摄影(均P<0.05);超声+超声弹性成像均高于常规超声、钼靶X线摄影和超声弹性成像(均P<0.05);超声与超声弹性成像比较差异无统计学意义(P>0.05)。结论常规超声无创、可重复性强,敏感性及特异性较高,可作为检查乳腺疾病的首选检查手段;钼靶X线摄影发现微小钙化优势显著;超声弹性成像有助于提高超声乳腺检查的准确性。超声联合弹性成像的综合应用,是评估触诊阴性乳腺病灶良、恶性的新方法,可提高早期乳腺癌的检出率。     

超声、MRI对钼靶BI-RADS Ⅲ~Ⅳ级乳腺病变的诊断效能比较

目的探讨超声、MRI对钼靶BI-RADSⅢ^Ⅳ级乳腺病变的诊断效能对比。方法收集经病理证实的39例女性患者共41个钼靶BI-RADSⅢⅣ级乳腺病变的诊断效能对比。方法收集经病理证实的39例女性患者共41个钼靶BI-RADSⅢ^Ⅳ级乳腺病灶,分析其超声及MRI影像表现,对比两种影像学检查方法的诊断效能。结果超声对BI-RADSⅢⅣ级乳腺病灶,分析其超声及MRI影像表现,对比两种影像学检查方法的诊断效能。结果超声对BI-RADSⅢ^Ⅳ级乳腺病变的诊断敏感度为92.3%、特异度为82.1%、阳性预测值为70.6%、阴性预测值为95.8%,MRI的诊断敏感度为92.3%、特异度为89.3%、阳性预测值为80.0%、阴性预测值为96.2%。超声、MRI的诊断准确性分别为85.4%、90.2%,经配对卡方检验两者间差异无统计学意义(P=0.687)。结论超声、MRI均可提高钼靶BI-RADSⅢⅣ级乳腺病变的诊断敏感度为92.3%、特异度为82.1%、阳性预测值为70.6%、阴性预测值为95.8%,MRI的诊断敏感度为92.3%、特异度为89.3%、阳性预测值为80.0%、阴性预测值为96.2%。超声、MRI的诊断准确性分别为85.4%、90.2%,经配对卡方检验两者间差异无统计学意义(P=0.687)。结论超声、MRI均可提高钼靶BI-RADSⅢ^Ⅳ级乳腺病变的检出率及准确率,提高早期乳腺癌的诊断准确性。     

彩色多普勒超声与钼靶X线联合诊断早期乳腺癌的研究

目的观察联合应用彩色多普勒超声和钼靶X线检查方法对早期乳腺癌诊断的作用。方法选取经外科手术或活检后病理证实为早期乳腺癌女性患者46例,回顾性分析彩色多普勒超声、钼靶X线检查及彩色多普勒超声联合钼靶X线检查诊断早期乳腺癌的阳性检出率。结果彩色多普勒超声、钼靶X线及彩色多普勒超声联合钼靶X线检查诊断早期乳腺癌的阳性检出率分别为82.6%(38/46),84.8%(39/46)和91.3%(42/46)。彩色多普勒超声联合钼靶X线检查诊断早期乳腺癌的阳性率显著高于彩色多普勒超声或钼靶X线单独检查的诊断阳性率(P0.05)。结论联合应用彩色多普勒超声和钼靶X线的检查方法,有助于提高乳腺癌的早期诊断。     

乳腺超声与钼靶摄影的比较与联合应用

目的比较乳腺超声、钼靶摄影以及二者结合在乳腺疾病诊断中的准确率。方法对1412例患者1461个乳腺病变（良性491个，恶性970个）根据超声声像图、钼靶摄影表现以及综合二者表现将病变恶性可能性分级，并与病理诊断结果对照。结果超声和钼靶摄影将全部病变分类为可能良性、不能定性、可能恶性者分别为452个、91个、918个和400个、199个、862个，恶性百分比分别为15．7％、25．3％、95．4％和13．3％、55．3％、93．6％。综合二种方法分类为可能良性、不能定性、可能恶性者分别有400个、71个和990个，恶性百分比分别为6．5％、8．5％和94．7％。ROC曲线分析显示综合二者时的ROC曲线下面积大于单独钼靶摄影（0．934对0．889，P〈0．01）。结论乳腺超声和钼靶摄影联合应用可提高对乳腺病变诊断的准确率。     

乳腺X线摄影、超声及磁共振诊断乳腺癌的性能评价

目的:探讨乳腺X线摄影、超声及MRI诊断乳腺癌的临床价值。方法:选取我院2011年7月-2017年6月乳腺病变患者129例,年龄26~75岁,平均(45.0±8.2)岁。所有患者均在1月内接受过乳腺X线摄影、超声及MRI检查,并对其诊断结果进行分析,比较阳性预测值(PPV)、阴性预测值(NPV)、准确性、灵敏度、特异度、ROC曲线及ROC曲线下面积(AUC)。结果:乳腺X线摄影、超声诊断乳腺癌的PPV和NPV均低于MRI (89.5%和98.1%)。MRI诊断乳腺癌的准确性(93.0%)、灵敏度(98.6%)、AUC(0.938)显著高于乳腺X线摄影的准确性(72.9%)、灵敏度(85.5%)、AUC(0.806)和超声的准确性(73.6%)、灵敏度(71.0%)、AUC(0.814)(P<0.000 1)。结论:MRI诊断乳腺癌的准确性、灵敏度、AUC均高于乳腺X线摄影及超声,MRI在诊断及鉴别乳腺良恶性肿瘤方面具有较高的临床价值,值得广泛应用。     

Preoperative staging of breast cancer by palpation, mammography and high-resolution ultrasound.

In breast cancer preoperative determination of the tumor size is important for planning breast-conserving operations. In 100 patients with breast cancer, the preoperative tumor size was measured using clinical, mammographic and sonographic examinations and correlated with the results of a subsequent histological examination. Using a high-resolution real-time system, 98 tumors were visible. It was possible to detect not only early tumors under 1 cm in diameter, but also intraductal tumor components. This contributed greatly to the accuracy of the diagnosis. The sonographic measurement of tumor size demonstrated a correlation coefficient of 0.91 and was thus superior to mammography (0.79) and palpation (0.77). Measurement of the total tumor spread, including 39 multicentric lesions, showed an overestimation of 5% for the mammographic measurements and an overestimation of 4% for the sonographic measurements. Tumor extension was underestimated in 33% of the mammograms but in only 3% using ultrasound examination. The results, along with those of other studies, highlight the role of sonography in the diagnosis of breast cancer.     

乳腺癌超声、MRI、X线征象与分子分型的相关性

超声、MRI、X线是临床对乳腺癌进行诊断、分期及随访的重要方法。随着乳腺癌个体化治疗的发展,乳腺癌各分子分型的划分对治疗方案的选择具有重要参考价值。对影像学检查方法的要求也从依据乳腺影像形态学特征检出乳腺癌发展为利用功能影像学检查对乳腺癌进行更为准确的判断,超声、X线和MRI的乳腺影像学特征与乳腺癌分子分型的相关性逐渐成为研究热点。本文对乳腺癌各分子亚型与超声、MRI、X线特征的相关性进行综述。     

Breast cancer screening and problem solving using mammography, ultrasound, and magnetic resonance imaging

Although mammography is the mainstay of early breast cancer detection, it has known limitations, particularly in women with dense breasts. As a result, additional imaging modalities, including ultrasound and contrast-enhanced magnetic resonance imaging, are also being used to supplement mammography in the early detection of occult breast cancer. This article reviews the indications and efficacy of mammography, ultrasound, and magnetic resonance imaging as both screening and diagnostic tools.     

Advances in ultrasound mammography: remote focus arc scanning

A new form of automated scanning has been developed which overcomes geometric and amplitude distortion and physical scanning limitations, associated with simple arc scanning. In simple arc scanning, the transducer rotates about a point located behind the viewed object. This produces a dense concentration of scan lines around the point of rotation, resulting in a V-shaped type of geometric distortion.Remote focus arc scanning, reported in this paper, results in an arc scan which reduces this geometric distortion by substituting an imaginary focal point placed at infinity for a true point source of rotation. This is accomplished by simultaneous simple arc and sector scanning motions. This type of scan is required for ultrasound mammography of large breasts.     

Prolactin levels and examination with breast ultrasound or mammography

Objective Stresses including surgery, exercise, nipple stimulation, and chest wall injury such as mechanical trauma, burns, surgery, herpes zoster of thoracic dermatomes, hypoglycaemia and acute myocardial infarction cause significant elevation of prolactin levels. The aim of the present study was to evaluate the changes in prolactin level during mammography and ultrasonographic examination. Materials and Methods: Seventy-four premenopausal (mean age, 32.1±7.3 y) and 81 post-menopausal women (mean age, 48.3±8.9 y) were enrolled into the study. Premenopausal women were evaluated with ultrasound (Senographe 600 T [General Electric]) and post-menopausal women were examined with mammography (Mammomat 3000 [Siemens]). Blood samples for prolactin were taken prior to ultrasound or mammography and 15, 30 and 45 min after ultrasound or mammography. Results: Mean baseline serum prolactin level was 7.2±0.9 ng/ml in premenopausal women before ultrasound. Mean baseline serum prolactin level was 5.4±0.4 ng/ml in post-menopausal women before mammography. It was found that there were no significant changes in prolactin levels after ultrasound or mammography (P>0.05). Mean levels of baseline prolactin were statistically significant higher in premenopausal than in post-menopausal women (P=0.03). Conclusion: Mammography and ultrasonographic examination have no acute effect on serum prolactin levels in either group. There is no need to wait before measuring the prolactin level after mammographic or ultrasonographic breast examination.     

The need for color coding in ultrasound mammography.

The correct interpretation of echo amplitude patterns of high-resolution gray scale ultrasonograms of the breast requires the use of calibrated color-coded isodensitometry, standardized operation of the ultrasound system, amplitude stability of 1 per cent or better, and a constant velocity water-coupled electro-mechanical scanner. The same conditions may be required for correct interpretation of the ultrasonograms of the parenchyma of the liver, spleen, ovaries, testes, uterus, thyroid, and tumors. Color coding is not required and may actually be detrimental in the study of gross ultrasonography anatomy and in disease states that can be identified by simple anatomical distortions. To be of value, rigid standardization and control of the amplitude characteristics and scanning velocity of the system are imperative.     

Comparison of ultrasound elastography, mammography, and sonography in the diagnosis of solid breast lesions.

OBJECTIVE: The purpose of this study was to evaluate the value of ultrasound elastography (UE) in differentiating benign versus malignant lesions in the breast and compare it with conventional sonography and mammography. METHODS: From September 2004 to May 2005, 296 solid lesions from 232 consecutive patients were diagnosed as benign or malignant by mammography and sonography and further analyzed with UE. The diagnostic results were compared with histopathologic findings. The sensitivity, specificity, accuracy, positive and negative predictive values, and false-positive and -negative rates were calculated for each modality and the combination of UE and sonography. RESULTS: Of 296 lesions, 87 were histologically malignant, and 209 were benign. Ultrasound elastography was the most specific (95.7%) and had the lowest false-positive rate (4.3%) of the 3 modalities. The accuracy (88.2%) and positive predictive value (87.1%) of UE were higher than those of sonography (72.6% and 52.5%, respectively). The sensitivity values, negative predictive values, and false negative rates of the 3 modalities had no differences. A combination of UE and sonography had the best sensitivity (89.7%) and accuracy (93.9%) and the lowest false-negative rate (9.2%). The specificity (95.7%) and positive predictive value (89.7%) of the combination were better, and the false-positive rate (4.3%) of the combination was lower than those of mammography and sonography. CONCLUSIONS: In a clinical trial with Chinese women, UE was superior to sonography and equal or superior to mammography in differentiating benign and malignant lesions in the breast. A combination of UE and sonography had the best results in detecting cancer and potentially could reduce unnecessary biopsy. Ultrasound elastography is a promising technique for evaluating breast lesions.     

超声与钼靶X线检查对乳腺癌诊断价值的比较

目的比较超声与钼靶X线对乳腺癌的诊断价值及其临床意义。方法对比分析75例经手术病理证实的女性乳腺癌患者术前超声和钼靶X线检查资料。结果超声、钼靶X线及二者联合检查对乳腺癌的诊断准确率分别为：73．3％、77．3％和90．7％。结论超声和钼靶X线检查简便、价廉,诊断准确率较高,是诊断乳腺癌的主要主要检测手段,若两种检查联合应用可提高乳腺癌的检出率和诊断准确率。