乳腺X线摄影、超声、MRI对乳腺非肿块强化病灶诊断价值的对照研究

目的：比较乳腺 X 线摄影、超声及 MRI 对乳腺 MRI 非肿块强化(NME)病灶的诊断效能。方法回顾性分析116例(123个病灶)患者乳腺 MRI NME 病灶的乳腺 X 线摄影、超声及 MRI 的影像学表现。结果病理结果恶性99例，良性24例，乳腺X 线摄影、超声及 MRI 的敏感度分别为72.73%、65.66%、84.85%，特异度分别为66.67%、79.17%、79.17%，准确度分别为71.54%、68.29%、83.74%，阳性预测值分别为90.00%、92.86%、94.88%，阴性预测值分别为37.21%、35.85%、55.88%。MRI 对 NME 病灶的敏感度、特异度、准确度、阳性预测值及阴性预测值均明显高于乳腺 X 线摄影和超声(P <0.05)。且 MRI 与 MRI+乳腺 X 线摄影及 MRI+乳腺 X 线摄影+超声结果相近，差别无统计学意义。结论MRI 对于乳腺 NME 病灶有较高的诊断价值，应作为首选检查方法。

The comparison of the diagnostic value of mammography,ultrasonography and MRI for breast non-mass enhancement lesions

Objective To compare the diagnostic efficacy of digital mammography,ultrasonography and MRI for breast non-mass enhancement (NME).Methods The digital mammography,ultrasonography and MRI data of 1 1 6 patients with 123 NME lesions on MRI were analyzed retrospectively.Results 99 lesions were malignant and 24 lesions were benign according to the pathologiacl result.The sensitivity of digital mammography,ultrasonography and MRI was 72.73%,65.66%,and 84.85%,respectively;The specificity was 66.67%,79.1 7%,and 79.1 7%,respectively;The accuracy was 71.54%,68.29%,and 83.74%,respectively;The positive pretictive value was 90.00%,92.86%,and 94.88%,respectively;The negative pretictive value was 37.21%,35.85%,and 55.88%,respectively.The sensitivity,specificity,accuracy,positive pretictive value and negative pretictive value of MRI were obviously higher than those of digital mammography and ultrasonography (P <0.05).The difference between the combinations and MRI alone were no statistically significant.Conclusion MRI have better diagnostic value,and could be used as the first choice examination for breast NME lesions.