乳腺X线摄影、磁共振对结构扭曲良恶性病变的对比分析

发布时间：2019-02-14 16:19

【摘要】：目的通过对比分析乳腺结构扭曲病变在乳腺X线摄影及磁共振的征象,探讨两种检查方法的诊断价值。方法收集经病理证实的患者59例,对乳腺X线摄影图像中结构扭曲密度、程度,有无伴随症状及磁共振中病灶有无强化,强化的形态、大小、数目进行分析。卡方检验分析各征象在良恶性病变中的分布差异,与病理对比,用ROC曲线评价两种检查对良恶性病变鉴别的诊断价值。结果 X线摄影图像中结构扭曲密度(P=0.000)及有无伴随症状(P=0.02),对鉴别病灶良恶性具有显著性意义;MRI中病灶无强化(P=0.000)、多灶性强化(P=0.008)及肿块样强化中直径10mm者(P=0.02)高度提示恶性病变,有统计学意义。以病理作为标准,X线摄影对结构扭曲病变的良恶性鉴别其ROC曲线下面积为0.699(95%CI:0.566-0.812),MRI的ROC曲线下面积为0.941(95%CI:0.847-0.986),两种检查方式的诊断效能具有显著性差异(P0.0001)。结论乳腺X线摄影是发现结构扭曲的最基本检查方法及主要手段,但对其良恶性鉴别还存在不少困难,MRI能更好的提高良恶性诊断的准确性。
[Abstract]:Objective to study the diagnostic value of two methods of mammography and magnetic resonance imaging (MRI). Methods 59 patients confirmed by pathology were collected to analyze the density, degree, concomitant symptom, enhancement, size and number of lesions in mammography. Chi-square test was used to analyze the distribution of various signs in benign and malignant lesions, and compared with pathology. The diagnostic value of two kinds of examinations in differential diagnosis of benign and malignant lesions was evaluated by ROC curve. Results the structural distortion density (P0. 000) and associated symptoms (P0. 02) in X-ray images were significant in differentiating benign and malignant lesions. The patients with no enhancement (P0. 000), multi focal enhancement (P0. 008) and middle diameter 10mm (P0. 02) in MRI showed malignant lesions with statistical significance. According to pathology, the area under ROC curve was 0.699 (area under ROC curve of 95%CI:0.566-0.812), MRI was 0.941 (95%CI:0.847-0.986). The diagnostic efficacy of the two methods was significantly different (P 0.0001). Conclusion mammography is the most basic examination method and main method for detecting structural distortion, but there are still many difficulties in differentiating benign and malignant lesions. MRI can improve the accuracy of diagnosis of benign and malignant lesions.
【作者单位】：江苏省昆山市中医医院放射科;复旦大学附属肿瘤医院放射科;
【分类号】：R737.9;R445.2;R730.44

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