核磁共振在需要活检的乳腺病灶诊断中的应用价值

目的探讨核磁共振（MRI）在需要活检乳腺病灶诊断中的应用价值。方法对接受诊治的108例患有乳腺疾病的妇女进行体格检查、超声检查和（或）乳腺X线检查,共发现116个病灶。在这些病灶中,三项检查中至少有一项提示恶性可能、需要接受手术活检。另外,在开放活检前还接受术前MRI检查。通过与病理对比,得出各影像学诊断的准确性。结果116个病灶中70个（60．3％）为恶性。超声检查的敏感性为83．3％,特异性为62．0％,准确性为74．1％,阳性预测值74．3％,阴性预测值73．8％。乳腺X线检查的敏感性为86．8％,特异性为68.1％,准确性为78．0％,阳性预测值75．4％,阴性预测值82．1％。MRI检查的敏感性为97.1％,特异性为73．9％,准确性为87．9％,阳性预测值85．0％,阴性预测值94．4％。结论MRI对需要活检的乳腺病灶诊断的敏感性、特异性、准确性、阳性预测值和阴性预测值均优于乳腺X线检查和超声检查,对临床上不可触及病灶的辅助诊断有较大应用价值。

Value of magnetic resonance imaging in diagnosing breast lesions which need biopsy

Objective To evaluate MRI in diagnosing breast lesions which need biopsy. Methods One hundred and eight patients were admitted to hospital for biopsies due to one hundred and sixteen suspicious lesions detected in their breasts. These lesions were detected by physical examination, mammography or ultrasonography. They were also administrated MRI examination before biopsy. The sensitivity and specificity of each diagnostic method were obtained and the radiologic-pathologic correlation was meanwhile calculated. Results Seventy (60. 3% ) breast lesions were diagnosed malignancy. The sensitivity, specificity, accuracy, positive prognostic value and negative prognostic value of ultrasonography were 83. 3% , 62. 0% , 74. 1% , 74. 3% and 73. 8%. Such data of mammography were 86. 8% , 68. 1% , 78. 0% , 75.4% and 82. 1%. And those of MRI were 97. 1% , 73. 9% , 87. 9% , 85. 0% and 94. 4%. Conclusion MRI is superior to ultrasonography and mammography in diagnosing breast lesions, especially for the nonpalpable lesions.