摘要
目的：对于增强磁共振和首次超声检查诊断不一致的乳腺病灶，再次进行超声检查，结合病理结果讨论第二次超声检查的意义。材料与方法：搜集2010年8月—2012年6月在我院先后进行乳腺超声检查和增强磁共振检查的女性患者。对于增强磁共振和超声检查诊断不一致的乳腺病灶，进行第二次超声检查。最后共有14名患者入组，获得18个病灶。这些病灶的确切诊断以手术后病理结果为金标准。乳腺病灶的影像诊断采用BI-RADS分类方法：BI-RADS 3类和4a、4b类病灶倾向良性，4c、5类倾向恶性。计算第二次超声检查和增强磁共振检查的敏感性、特异性、准确性、阳性预测值和阴性预测值。采用Fisher确切概率法对第二次超声和增强磁共振检查的各个诊断率进行检验，P<0.05（双侧）有统计学意义。结果：18个病灶中最后经病理证实良性病变14个、恶性病变4个。第二次超声检查和增强磁共振检查的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为75%、92.86%、88.89%、75%、92.86%和75%、50%、55.56%、30%、87.5%。结论：对于增强磁共振和首次超声检查诊断不一致的乳腺病灶，第二次超声检查是有价值的。第二次超声检查的特异性优于增强磁共振。
Abstract
Objective: To assess the significance of second-look ultrasound for breast lesions with different diagnosis between enhanced magnetic resonance imaging(MRI) and ultrasound. Materials and Methods: From August 2010 to June 2012, female patients undertaking ultrasound and enhanced MRI were collected successively. For breast lesions with different diagnosis between enhanced MRI and ultrasound, second-look ultrasound(SLUS) was applied. Finally, 14 women were collected, and 18 lesions were acquired. The final diagnosis for the breast lesions was based on the pathological diagnosis, so-called golden standard. BI-RADS(Breast imaging reporting and data system) was used in the diagnosis with ultrasound and MRI: lesions of BI-RADS 3, BI-RADS 4a and BI-RADS 4b were considered as benignity. However, lesions of BI-RADS 4c and BI-RADS 5 were considered as malignancy. Sensitivity, specificity, accuracy, positive and negative predictive values(PPV and NPV) of second-look ultrasound and enhanced MRI were calculated. The diagnostic rate was tested by Fisher’s exact test. When P<0.05(double tail), the test was significant. Results: In the 18 lesions confirmed by pathology, 14 lesions were benign and 4 lesions were malignant. The sensitivity, specificity, accuracy, PPV and NPV of second-look ultrasound and enhanced MRI were 75%, 92.86%, 88.89%, 75%, 92.86% and 75%, 50%, 55.56%, 30%, 87.5%, respectively. Conclusion: For breast lesions with different diagnosis between enhanced MRI and ultrasound, second-look ultrasound is valuable. The specificity of second-look ultrasound is superior to enhanced MRI.
关键词
乳腺疾病 /
超声检查 /
磁共振成像
Key words
Breast diseases /
Ultrasonography /
Magnetic resonance imaging
王 博;李 晶;杨 威;张 伟.
对乳腺病灶进行第二次超声检查的意义[J]. 中国临床医学影像杂志. 2014, 25(12): 848-851
WANG Bo;LI Jing;YANG Wei;ZHANG Wei.
Significance of second-look ultrasound for breast lesions[J]. Journal of China Clinic Medical Imaging. 2014, 25(12): 848-851
中图分类号：
Ｒ655.8
Ｒ445.1
Ｒ445.2
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