磁共振在乳腺癌术后复查中的临床应用价值探讨

发布时间：2018-05-01 20:08

本文选题：乳腺癌 + 术后复查　；参考：《首都医科大学》2017年硕士论文

【摘要】：目的:本研究以病理和临床为对照,探讨磁共振成像技术在乳腺癌术后是否复发诊断及鉴别诊断价值,同时寻找判断乳腺癌术后是否复发的最佳扫描序列。材料与方法:选取2010年1月-2016年12月期间在我院同时行乳腺癌术后MRI和超声复查的女性患者52例(复查时患者平均年龄56.5岁,复查距手术平均时间为48.3个月)。以病理和临床为对照,回顾性分析MRI、超声两种检查方法在诊断乳腺癌是否复发时的敏感度、特异度,以及影像检查结果与病理临床结果的一致性;并分析不同MRI扫描序列在诊断乳腺癌术后是否复发中的价值。结果:52例患者中,MRI诊断为复发24例,经手术病理证实23例,误诊一例,MRI诊断为瘢痕形成或未见复发29例,全部经随访或手术证实无复发。超声诊断为复发23例,其中5例经随访无复发,超声诊断为无复发29例,其中5例漏诊复发。MRI、超声检查的敏感度分别为100%、78.3%,特异度分别为96.5%、82.8%,准确性分别为98.1%、80.8%。MRI与病理随访资料的一致性较好(MRI、超声诊断kappa值分别为0.961、0.61)。MRI图像中,动态增强早期出现强化病灶表现与乳腺癌复发的符合程度最高(kappa值为0.961)。结论:MRI在判断乳腺癌术后复发和瘢痕中具有很高的准确性,与临床病理结果的一致性优于超声检查,可以作为乳腺癌术后的常规检查手段。同时,磁共振动态增强扫描对乳腺癌复发的检出意义最大。
[Abstract]:Objective: to investigate the value of magnetic resonance imaging (MRI) in the diagnosis and differential diagnosis of postoperative recurrence of breast cancer, and to find out the best scan sequence for judging the recurrence of breast cancer. Materials and methods: from January 2010 to December 2016, 52 female patients with breast cancer underwent MRI and ultrasound examination simultaneously (mean age was 56.5 years), and the average time from reexamination to operation was 48.3 months. The sensitivity, specificity and consistency of MRI and ultrasonography in the diagnosis of breast cancer recurrence were analyzed retrospectively. The value of different MRI sequences in the diagnosis of postoperative recurrence of breast cancer was analyzed. Results among 52 cases, 24 cases were diagnosed as recurrence by MRI, 23 cases were proved by operation and pathology, 29 cases were diagnosed as scar formation or no recurrence by misdiagnosis by MRI. No recurrence was confirmed by follow-up or operation. Among the 23 cases diagnosed by ultrasound, 5 cases had no recurrence and 29 cases had no recurrence after follow up. Among them, the sensitivity of ultrasound examination was 100 and 78.3, the specificity was 96.5and 82.8, the accuracy was 98.1and 80.8.MRI was consistent with the pathological follow-up data. The kappa value of ultrasonography was 0.961and 0.61MRI, respectively, in MRI images, the sensitivity of ultrasonography was 78.3%, the specificity was 96.5% and 82.8%, and the accuracy was 98.1 and 80.8%, respectively. Dynamic contrast enhanced early enhanced lesions had the highest coincidence with breast cancer recurrence, and the kappa value was 0.961g. Conclusion Mr imaging has a high accuracy in judging the recurrence and scar of breast cancer after operation, and the consistency with clinicopathological results is superior to that of ultrasound, and it can be used as a routine examination method for breast cancer after operation. At the same time, dynamic contrast enhanced MRI is the most important in the detection of breast cancer recurrence.
【学位授予单位】：首都医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.9;R445.2

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