多层螺旋CT对乳腺癌诊断的意义

目的探讨多层螺旋CT(MSCT)对乳腺癌的诊断价值。方法对连续120例临床和(或)其他影像方法拟诊乳腺癌的患者进行前瞻性MSCT研究。开始注射对比剂后35s(动脉早期)启动动态增强扫描,并于60s和150s重复扫描。然后将CT诊断与手术病理结果作对照研究,计算CT诊断乳腺癌的准确率。结果本组120例中经手术及病理证实为乳腺癌者89例100个病灶,其中浸润性导管乳腺癌61例,导管原位癌12例,浸润性小叶癌8例,髓样癌6例,炎性乳腺癌2例。分别按照病灶形态学、病灶强化特征、病灶强化的时间—密度曲线及上述三者综合分析,并进行CT诊断,准确率分别为78%、82%、84%和92%。结论MSCT在乳腺癌诊断中具有较大的临床价值。

Diagnosis of Breast Carcinoma by Multislice Spiral CT

Objective To explore the diagnostic value of multislice spiral CT (MSCT) for breast carcinoma.Methods One hundred and twenty consecutive suspicious cases of breast carcinoma diagnosed clinically and/or by imaging modalities were studied with MSCT prospectively. The dynamic contrast-enhanced serial scanning was done as follows:Scanning was triggered 35 s (early arterial phase) after beginning of contrast agent infusion at a speed of 3 mL/s by high pressure automatic injector, and would be repeated at the time point of 60 s and 150 s. Eventually, the CT diagnostic results were compared with the pathological consequences to calculate the diagnostic accuracy of MSCT for breast carcinoma. Results Eighty-nine patients with 100 foci of breast cancer from 120 suspicious cases were confirmed pathologically and their imaging data were analyzed. Among the 89 cases, 61 cases were invasive ductal carcinomas,12 ductal carcinomas in situ, 8 invasive lobular carcinomas, 6 medullary carcinomas and 2 inflammatory carcinomas. According to lesion morphologic appearance, lesion enhancement mode, time-density curve of lesion, and combination of all the above three parameters, the diagnostic accuracies were 78%, 82%, 84% and 92%, respectively. Conclusion MSCT has a great clinical value in diagnosing breast carcinoma.