MRI相比CT在诊断乳腺癌方面优势分析.docVIP

MRI相比CT在诊断乳腺癌方面优势分析 　　[摘要] 目的 探?CT和MRI在诊断不同病理类型乳腺癌的临床效果。 方法 回顾性分析2016年6月～2017年6月我院乳腺外科收治的经术中或穿刺病理确诊为乳腺癌的患者86例，另取同期经病理证实为乳腺良性肿块患者33例作为研究对象。分析乳腺癌患者的MRI和CT表现，对比MRI和CT对乳腺癌的检出率、灵敏度、特异度和阳性似然比。将乳腺癌患者按病理类型分为乳腺导管内原位癌（DCIS）、浸润性小叶癌（LDC）、浸润性导管癌（IDC）三组，分析对比MRI和CT对不同病理类型乳腺癌的诊断和鉴别诊断价值。 结果 CT检测出乳腺癌患者75例共81个病灶，直径为（0.9～8.1）cm，淋巴结转移17例，局部浸润22例，CT平扫显示肿块呈不规则低密度，皮肤增厚，局部可有钙化点，增强后肿块明显强化。MRI检出乳腺癌80例共85个病灶，直径为（1.2～8.1）cm，淋巴结转移18例，局部浸润24例，肿瘤在MRI T1WI序列中多呈边界不清的低信号，T2WI序列为不均匀高信号，动态增强扫描早期明显强化，与周围组织边界清楚。MRI与CT对乳腺癌的检出率分别为93.0%（80/86）和87.2%（75/86），差异无统计学意义（P0.05）；MRI与CT诊断乳腺癌的灵敏度分别为94.1%和88.2%，特异度分别为87.9%和79.4%，阳性似然比分别为7.78和4.28，以上两组数据的差异均有统计学意义（P0.05）。 结论 MRI诊断乳腺癌灵敏度和特异度均高于CT，尤其对导管内原位癌检出率高，在乳腺癌的早期诊断方面临床价值优于CT。 　　[关键词] 磁共振；计算机X线断层扫描；乳腺癌；病理类型；鉴别诊断 　　[中图分类号] R737.9 [文献标识码] B [文章编号] 1673-9701（2017）27-0102-03 　　Analysis on the advantages of MRI in the diagnosis of breast cancer compared with CT 　　LI Denghua 　　CT/MRI Room， Nanchang Third Hospital， Nanchang 330009， China 　　[Abstract] Objective To explore the clinical effect of CT and MRI in the diagnosis of breast cancer with different pathological types. Methods 86 patients who were admitted to the Department of Breast Surgery in our hospital and diagnosed as breast cancer during the surgery or via puncture pathology from June 2016 to June 2017 were retrospectively analyzed. Another 33 patients with benign breast masses confirmed by pathology during the same period were selected as the research subjects. The MRI and CT findings were analyzed in the patients with breast cancer. The detection rate， sensitivity， specificity and positive likelihood ratio of MRI and CT to breast cancer were compared. The patients were divided into three groups of ductal carcinoma in situ group（DCIS）， invasive lobular carcinoma（LDC） and invasive ductal carcinoma（IDC） according to the types of breast cancer. The values of diagnosis and differential diagnosis of MRI and CT for different pathological types of breast cancer were analyzed and compared. Results A total of 81