乳腺肿物的超声自动容积成像与增强磁共振诊断对比研究

摘要

Objective To compare the value of automatic breast volume scanner (ABVS) with enhanced magnetic resonance imaging(MRI) in the diagnosis of breast masses.Methods Seventy-four patients with 80 breast masses underwent preoperative ultrasound examinations including ABVS and MRI.The values of ABVS and MRI in the diagnosis of breast masses were comparatively analyzed.Results Among the 80 breast masses that were surgically removed,37 masses were benign and 43 masses were malignant.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ABVSin the diagnosis of breast malignant masses were 94.6％,79.1％,86.3％,79.5％ and 94.4％,respectively,those of MRI were 94.6 ％,86.0 ％,90.0 ％,85.4 ％ and 94.9 ％,respectively,and those of the combination of ABVS and MRI were 94.6％,93.0％,93.8％,92.1％,and 95.2％,respectively.The sensitivity and specificity were not significant difference between ABVS and MRI in the diagnosis of breast malignant masses(P ＞0.05).The specificity of the combination ABVS and MRI in the diagnosis of breast malignant masses were significantly higher than that of ABVS (x2 =4.17,P =0.04).The sensitivity,specificity and accuracy of convergence sign in the diagnosis of breast malignant masses were 64.9 ％,97.7 ％ and 82.5 ％,respectively.Conclusions ABVS and MRI are both valuable in the diagnosis of breast masses,and the combination of ABVS and MRI is the most valuable due to high specificity.%目的 比较乳腺超声自动容积成像(automated breast volume scanner,ABVS)与增强磁共振(magnetic resonance imaging,MRI)对乳腺肿物的诊断价值.方法 应用ABVS、增强MRI对74例乳腺肿物患者共80个病灶进行检查,比较ABVS与增强MRI对乳腺肿物的诊断效能.结果 80个乳腺肿物经术后病理证实,恶性37枚,良性43枚,ABVS诊断乳腺癌的敏感度为94.6％,特异度为79.1％,准确度为86.3％,阳性预测值为79.5％,阴性预测值为94.4％;增强MRI诊断乳腺癌的敏感度为94.6％,特异度为86.0％,准确度为90.0％,阳性预测值为85.4％,阴性预测值为94.9％;二者联合诊断乳腺癌的敏感度为94.6％,特异度为93.0％,准确度为93,8％,阳性预测值为92.1％,阴性预测值为95.2％.ABVS与增强MRI诊断乳腺癌敏感度、特异度差异无统计学意义(P＞0.05),二者联合诊断特异度较ABVS高,差异具有统计学意义(x2=4.17,P=0.04).ABVS“汇聚征”诊断乳腺癌敏感度、特异度、准确度分别为64.9％、97.7％、82.5％.结论 ABVS与增强MRI对乳腺肿物均具有较高诊断价值,二者联合可提高诊断特异度.