MR动态增强检查在评估乳腺肿块切除术后恶性残留中的临床价值

发布时间：2018-05-19 07:47

本文选题：乳腺肿块切除术 + 残留　；参考：《实用医学杂志》2015年18期

【摘要】：目的:探讨对于乳腺肿块切除术后,病理检查提示恶性的患者,MR动态增强检查在评估癌灶残留中的临床应用价值。方法:对53例行单纯肿块切除术后病理提示恶性的患者,在2次手术前,行MR动态增强检查,MR诊断与2次手术后病理结果进行对照分析。结果:MR动态增强检查中,32%(17/53例)的乳腺内发现异常强化灶。肿块样强化8例,占47%,其中6例病理证实有癌灶残留(P0.01);局灶性强化6例,占35%,其中1例病理证实有癌灶残留(P0.01);导管样强化3例,占18%,其中2例病理证实有癌灶残留(P0.05);MR动态增强检查中,68%(36/53)的乳腺内没有发现异常强化灶,其中33例病理证实无癌灶残留,占92%;3例病理证实有癌灶残留,占8%。MR动态增强检查的阳性预测值、阴性预测值分别为52%和92%。结论:MR动态增强检查可以较为准确地评估肿块切除术后的患乳内有无癌灶残留及其分布范围,为2次手术方案的制定提供重要参考,具有重要的临床应用价值。
[Abstract]:Objective: to evaluate the clinical value of dynamic contrast-enhanced Mr (Mr) in the evaluation of tumor residual in malignant patients after mastectomy. Methods: 53 patients with malignant tumor after simple mass resection were examined with Mr dynamic contrast enhanced Mr before 2 operations and compared with the pathological results after two operations. Results abnormal enhancement was found in 32 / 53 cases of breast on Mr dynamic enhancement. Tumor-like enhancement was found in 8 cases (47%), in which 6 cases were confirmed by pathology to have residual tumor P0.01, 6 cases were focal enhancement (35%), 1 case was confirmed by pathology to have residual tumor P0.01, 3 cases were ductal enhancement. Of the 18 cases, there were no abnormal enhancement lesions in 68 / 36 / 53 mammary glands in 2 cases with pathologically confirmed residual lesions (P0.05 / 53), 33 of which were confirmed by pathology as having no residual lesions, and 3 cases were confirmed by pathology as having residual lesions of cancer, and 3 cases were confirmed by pathology as having residual lesions in the breast, among which 33 cases were confirmed as having no residual lesions by pathology, and 3 cases were confirmed by pathology as having residual lesions. The positive predictive value and negative predictive value were 52% and 92% respectively. Conclusion the dynamic enhanced Mr examination can accurately evaluate the residual tumor and its distribution in the breast after mass resection. It provides an important reference for the formulation of two surgical procedures and has an important clinical application value.
【作者单位】：湖北省武汉市中心医院影像科;
【分类号】：R737.9;R445.2

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