超声和钼靶X线诊断乳腺癌的价值比较.doc

DEPARTMENT ONE COMPARISON OF MAMMOGRAPHY AND ULTRASONO- GRAPHY IN DIAGNOSIS OF BREAST CANCER ABSTRACT Background Breast cancer is one of the commonly malignant neoplasms endangering health of women. It has clambered up the first most common cancer in Chinese women in recent years. A realistic strategy for the reduction of breast cancer mortality rates is to diagnose the disease while it is still in an early stage. Mammography is the most frequently used modality in screening breast cancer in western countries, nevertheless, its sensitivity of detection is reduced in women with radiographically dense breasts. This is also a problem for Chinese women with small, dense breasts. Ultrasonography is very useful in detection of lesions, even in dense breasts while less sensitive to microcalcifications. The mean problem for radilogists is to improve the detection of breast cancer and reduce the false-positive by combination the advantages of the two modalities. Part Ⅰ Comparison of gray-scale and Doppler sonography in diagnosis of breast cancer Purpose: To determine the value of gray-scale US and Doppler sonography in differentiation breast cancer. Methods: 382 consecutive patients underwent gray-scale US and Doppler US, V respectively. Each lesion characteristic was described and classified according to the BI-RADS system. Taking category 1, 2 and 3 as benign, category 4 and 5 as malignant, then compared with histopathological diagnosis. Results: 1. Sensitivity, specificity and PPV for the descriptor “irregular shape” and “not circumscribed margins” were 83.7%, 69.9%, 72.6% and 90.2%, 69.5%, 74.9%, respectively. Of the margins, PPV for angular or speculated and microlobulated were % and 80%. Sensitivity, specificity and PPV for the descriptor posterior acoustic feature “shadowing” and lesions with calcifications were 30.7%, 94.2%, 83.5% and %, 92.4%, 83.1%, respectively. The sign of “nonparallel orientation” had 32.1% sensitivity, 77.9%specifity and 60%PPV. Penetrating ve