乳腺癌术后患者胸部磁共振检查的评价

目的 探讨MRI在乳腺癌根治术后患者胸部复查中的价值和限度。材料与方法 搜集乳腺癌根治术后作胸部MRI检查的20例患者，均为女性，年龄39－70岁，平均51岁。观察分析MRI表现（包括胸壁、内乳淋巴结、腋下淋巴结、纵隔和肺门淋巴结、胸膜、骨、肺及肩部软组织等8个部位），分别计算敏感性、特异性和准确性。另对12例同时有MRI和SPECT检查的患者进行初步比较。结果 MRI的总体敏感性为86．3％，特异性为99．5％，准确性为96．9％。尤其对胸壁和内乳区病变，上述三特性均达100％。对骨转移的敏感性为83．3％，特异性为100％，准确性为96．7％；MRI对扁平骨（如肋骨和肩胛骨）转移易漏诊，因而导致敏感性偏低。结论 胸部MRI检查对乳腺癌术后胸部复发是较好的影像学方法，有助于临床制定治疗方案。

Evaluation of Thoracic MRI in Patients with Breast Cancer after Radical Mastectomy

Objective To evaluate thoracic MRI in re-examining patients withbreast cancer after radical mastectomy.Materials and Methods Chest MRI was performed in 20 female patients (39～70 years old, mean 51) with breast cancer after radical mastectomy. The thoracic structures, including the chest wall, the internal mammary, axillary, mediastinal and hilar lymph nodes, the pleura, the bone, the lungs and the soft tissue of the shoulders, were closely observed. The sensitivity, specificity and accuracy of MRI were calculated respectively. A preliminary comparison between MRI and SPECT was made in 12 patients who had undergone both examinations.Results The total sensitivity, specificity and accuracy were 95.8%, 98.2% and 92.5%, respectively. For the lesions located in chest wall or internal mammary area, all the above three statistic results were 100%. For bone metastases, the sensitivity, specificity and accuracy were 83.3%, 100% and 96.7%, respectively. The metastatic lesions in flat bone, such as rib or scapula, tended to be missed on MRI, resulting in a lower sensitivity to these lesions.Conclusion Thoracic MRI is an effective and practical examination for patients with recurrent breast cancer after radical mastectomy, and is very helpful for making the therapeutic plan.