彩色多普勒超声及乳腺钼靶X射线影像在乳腺原位癌早期诊断的对比分析

目的 探讨彩色多普勒超声检查及乳腺钼(Mo)靶X射线影像在乳腺原位癌中的诊断价值.方法 选择2003年10月至2009年9月在本院住院并经术后组织病理学诊断证实为乳腺原位癌的21例患者为研究对象.采用回顾性分析法,对其临床资料、彩色多普勒超声结果及乳腺钼靶X射线影像结果进行分析,并按照乳腺影像学报告和数据系统(BI-RADS)分级标准进行分级,并采用Cohen kappa(k值)统计方法评估两种分级方法的符合程度.结果 21例患者的彩色多普勒超声结果按照BI-RADS及BI-RADS关于超声诊断(BI-RADS-US)分级标准进行分级的结果:2例(9.52%)为5级;15例(71.42%)为4级(4A亚级为5例,4B亚级为4例,4C亚级为6例);4例(19.04%)为3级.乳腺钼靶X射线影像结果按照BI-RADS分级标准:2例(9.52%)为2级;3例(19.04%)为3级;13例(61.90%)为4级(4A亚级为3例,4B亚级为7例,4C亚级为3例);3例(14.29%)为5级.21例患者乳腺钼靶X射线影像和彩色多普勒超声的BI-RADS分级(≥4级)结果完全一致为15例(71.42%).Cohen Kappa(k)值为0.73(>0.6),表明两种诊断方法的BI-RADS分级结果一致性良好.结论 乳腺钼靶X射线影像及乳腺彩色多普勒超声结果的BI-RADS与BI-RADS-US分级检查结合临床检查对于乳腺原位癌的早期诊断具有重要意义.

Comparative Study on Molybdenum Target X-Ray Radiography and Color Doppler Ultrasonography in Diagnosis of Breast Carcinoma in Situ

Objective To explore the diagnostic value of molybdenum(Mo) target X-ray radiography and color Doppler ultrasonography in breast carcinoma in situ.Methods From October 2003 to September 2009,the clinical data of 21 cases with breast carcinoma in situ were selected into this study.The data of molybdenum target X-ray radiography and color Doppler ultrasonography were retrospectively analyzed by Breast Imaging Reporting and Data System(BI-RADS) and BI-RADS ultrasonography(BI-RADS-US).Informed consent was obtained from all participates.Results The color Doppler ultrasound results of 21 cases which were analyzed by BI-RADS-US classification showed,grade 5 were 2 cases(9.52%),grade 4 were 15 cases(71.42%,including grade 4A were 5 cases,4B were 4 cases,4C were 6 cases),grade 3 were 4 cases(19.04%).The molybdenum target X-ray radiography of 21 cases which were analyzed by BI-RADS classification showed,grade 5 were 3 cases(14.29%),grade 4 were 13 cases(61.90%,including grade 4A were 3 cases,4B were 7 cases,4C were 3 cases),grade 3 were 3 cases(19.04%),grade 2 were 2 cases(9.52%).The consistency rate of two methods(≥grade 4)was 71.42%(15/21).The Cohen Kappa(κ value) was 0.73(>0.6). Conclusions The BI-RADS classification of molybdenum target X-ray radiography combined with BI-RADS-US classification of color Doppler ultrasonography,and other clinical tests in diagnosis of breast carcinoma in situ is of important value.