Purpose To investigate combined application of ultrasound, mammography, MRI in preoperative assessment of breast cancer. Materials and Methods Fifty-eight patients were examined by the ultrasound (US), mammography (MG) and MRI before operation. All the cases were confirmed by percutaneous needle puncture or pathological examination. The detection rate, determining tumor size, lymph node metastasis and change in management of the three modalities and joint application were evaluated. Results In all of the examination methods, mammography showed the lowest sensitivity in detecting IDC and LDC lesions (P < 0.05). Combined use of ultrasound, mammography and MRI were more sensitive than US for detecting invasive and DCIS lesions (P < 0.05), and more accurate than mammography in diagnosing metastatic lymph nodes (P < 0.05). MRI was the most accurate in measuring tumor size with US better than mammography (P = 0.000). In 25 patients planned for breast conserving surgery, the management was changed by ultrasound in 2 patients (8.0%), by mammography in 1 patient (4.0%), by MRI in 5 patients (20.0%) and by intraoperative pathology in 1 patient (4.0%). Conclusion Application of ultrasound, mammography combined with MRI can improve breast cancer diagnosis and provide more detailed and accurate evidence for better management.%目的 探讨超声、钼靶X线联合MRI在乳腺癌术前评价中的作用.资料与方法 经超声、钼靶X线和MRI检查后拟诊为乳腺癌的58例患者,均经手术或穿刺病理证实,比较三种检查方法对癌灶检出率、癌灶大小符合率、淋巴结转移情况及手术方式的影响.结果 钼靶X线对癌灶的检出率及对浸润性导管癌(IDC)和浸润性小叶癌(LDC)的检出率最低(P＜0.05);超声、钼靶X线和MRI联合对癌灶的检出率和对导管内原位癌(DCIS)的检出率均高于超声(P＜ 0.05),对转移淋巴结的检出率高于钼靶X线、MRI(P＜0.05);癌灶影像学测值与病理测值的符合度:MRI最高,超声次之,钼靶X线最低(P=0.000).对手术方案的影响:拟行保乳术25例,最终实施16例,超声、钼靶X线、MRI和术中病理分别使2例(2/25,8.0％)、1例(1/25,4.0％)、5例(5/25,20.0％)、1例( 1/25,4.0％)改行根治术.结论 超声、钼靶X线联合MRI可进一步确诊乳腺癌,并对手术方案的确立提供更详细准确的依据.
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