摘要
目的:通过与常规乳腺X线摄影(MG)和对比增强乳腺MRI(CE-MRI)进行对比分析,探讨对比增强能谱乳腺X线摄影(CESM)对乳腺癌的临床诊断价值。方法:将临床拟诊为乳腺癌的63例患者纳入研究。在碘对比剂注射前后分别行双侧乳腺摄影术得到常规MG和CESM图像。CE-MRI采用快速梯度回波序列乳腺容积成像技术(VIBRANT)。由3位有经验的乳腺影像医师对所有图像进行分析,并对可疑病灶的最大径线进行测量。每种成像技术的诊断结果均与病理结果进行对照分析。结果:63例中乳腺癌42例,良性病变21例。CESM、CE-MRI和MG对乳腺病变的诊断符合率分别为66.67%(42/63)、65.08%(41/63)和57.14%(36/63),CESM对乳腺病变的诊断符合率比CE-MRI和MG要高,但3种方法间差异无统计学意义(P>0.05);CESM对乳腺恶性病变的诊断敏感度高(100%),但特异度较低(42.9%)。三组图像上测量的病灶最大径分别为(28.33±17.24)、(26.50±16.21)和(26.45±15.94)mm,与组织病理学测量值间差异均无统计学意义(P>0.05)。结论:对比增强能谱乳腺X线摄影对乳腺癌的诊断准确性较高,优于常规乳腺X线摄影,有望成为诊断乳腺病变的重要手段。
Objectire：To investigate the feasibility of contrast enhanced spectral mammography （CESM）in the diag-nosis of breast cancer by using a comparative study with MG and CE-MRI.Methods：After ethical approval,63 women with suspected breast cancer underwent CESM,MG and CE-MRI.MG and CESM were performed before and after injection of nonionic iodinated contrast agent.CE-MRI was performed using a VIBRANT sequence after injection of Gd-DTPA.All the images were analyzed by three experienced breast radiologists,and the maximum dimension of lesions were measured.The diagnostic results of three imaging methods were compared to pathological results.Results：Of 63 cases,there were 42 malig-nant lesions and 21 benign lesions.The diagnostic accuracy of CESM、CE-MRI and MG for breast lesions was 66.67% （42/63）,65.08% （41/63）and 57.14 （36/63）,with no significant difference among the three methods （P〉0.05）;in diagnosis of malignant breast lesions,the sensitivity of CESM was high （100%）,but the specificity （42.9%）was low.The average maximum dimension of the breast cancers measured by CESM,MG and CE-MRI was （28.33±17.24）,（26.50±16.21）and （26.45±15.94）mm,with no significant difference （P〉0.05）when compared with the pathological results respectively. Conclusion：Our Preliminary results show that the diagnostic accuracy of CESM in detection of breast cancer is excellent and higher than that of MG,so it may be an important diagnostic method for breast lesions.
出处
《放射学实践》
2014年第12期1420-1423,共4页
Radiologic Practice
基金
浦江计划(14PJD028)
上海市科委项目(114119a0800
11ZR1429300)
