3种影像学检查方法在乳腺癌早期诊断中的作用

目的探讨不同影像学检查方法在乳腺癌早期诊断及乳腺良恶性疾病鉴别诊断中的意义。方法回顾性总结2004年至2008年在北京世纪坛医院就诊治疗的310例乳腺疾病患者的资料,以病理检查结果为诊断标准,比较超声、钼靶X线和两者联合检查在乳腺癌早期诊断和良恶性疾病鉴别诊断中的作用。总结了20例加做核磁共振(MRI)的乳腺癌病例,探讨其在乳腺癌早期诊断中的意义。结果超声对乳腺癌诊断的符合率为85%,对乳腺良性疾病符合率为89.5%,钼靶X线对乳腺癌诊断的符合率为86%,对乳腺良性疾病的符合率为83.8%,两者联合诊断乳腺癌的灵敏度符合率为95%。在行MRI检查的20例患者中,三者联合应用的诊断符合率达100%。经统计学分析,超声和钼靶X线单独监测的诊断准确率差异无统计学意义,联合监测和单独监测相比差异有统计学意义。结论①联合应用超声和钼靶X线检查是现阶段早期诊断乳腺癌的首选方法;②MRI可作为超声和钼靶检查必要的补充方法;③钼靶X线在乳腺癌癌前病变-乳腺非典型增生的诊断中具有重要意义,是诊断乳腺非典型增生的较好方法。

Comparison of Three Imaging Methods in the Early Diagnosis of the Breast Cancer

Objective To study the value of 3 different imaging methods in the early diagnosis of breast cancer and differential diagnosis of benign versus malignant nature of breast tumors. Methods Three hundred and ten patients with breast disease seen from 2004 to 2008 were randomly selected in this study. Diagnosis of all the patients were confirmed by means of surgery and pathological examinations, and all the patients were examined by high frequency ultrasound and mammography before operation. Using the results of pathologic examination as the gold standard, the authors compared the result of high frequency ultrasound with that of mammography, and compared the result of any one method with the combined results of the other two. The authors also reviewed the results of 20 patients with breast carcinoma in whom magnetic resonance imaging was additionally applied to see its value in the diagnosis on breast carcinoma. Results The rate of consistency of the ultrasound on diagnosing breast carcinoma was 85 percent, while that of breast benign disease was 89.5 percent. The rate of consistency of the mammography on diagnosing breast carcinoma was 86 percent, while that of breast benign disease was 83.8 percent. The ultrasound could identify 85 of the 100 cases with breast carcinoma. While the mammography could make diagnosis for 86 of 100 patients with breast carcinoma. The combination of the both could make diagnosis for 95 of the 100 patients with breast carcinoma. In the 20 patients with breast carcinoma who were examined by magnetic resonance imaging, the accordance rate for diagnosis with the combination of the three was 100 percent. Though no significant difference in the diagnostic accuracy was found between the ultrasound and the mammography, the combination of the both could greatly elevate the diagnosis accuracy. Conclusion 1 The combination of mammography and high frequency ultrasound can be the first choice of methods to diagnose breast carcinoma in the early stage; 2 MRI can be a good supplement to mammography and high frequency ultrasound; 3 Mammography has great importance in diagnosing breast precancerosis-breast atypical hyperplasia, it is a much better method to diagnose breast atypical hyperplasia.