Accuracy of Mammography, Color Doppler Ultrasonography and Magnetic Resonance Imaging in Predicting Ductal Carcinoma in Situ
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摘要: 目的 探讨如何合理选用钼靶(mammography, MG)、彩超(color Doppler ultrasonography, CDUS)、磁共振(magnetic resonance imaging，MRI)对乳腺导管原位癌（ductal carcinoma in situ，DCIS）进行诊断。方法 收集2009年7月—2014年9月贵阳医学院临床医学院收治的DCIS患者资料，对26例资料完整的患者术前影像学资料进行总结分析，并用Kruskal-Wallis方法进行检验。结果 DCIS在钼靶X线上的表现有钙化（73%, 19/26）、结构紊乱（36%, 8/26）、结节（30%, 7/26），其中特征性的表现为密集细小钙化（70%, 18/26）；在彩超上的表现有结节（85%, 22/26）、导管扩张（11.5%,3/26），其中典型的表现为无包膜、低回声结节（59%, 13/22）；在MRI增强上的特征表现为非肿块样强化病灶（73%, 19/26），病灶时间-信号强度（TIC）曲线多呈Ⅱ、Ⅲ型（73%, 19/26）。钼靶、彩超、磁共振对DCIS诊断率分别为77%、50%、85%，钼靶联合彩超为85%，三者联合为96%，差异有统计学意义（P＜0.05)。结论 钼靶、彩超、磁共振均可发现DCIS，各具优势，不同影像学检查相应结合，可有效提高DCIS诊断率。Abstract: Objective To investigate the accuracy of mammography(MG), color Doppler ultrasonography(CDUS) and magnetic resonance imaging(MRI) in predicting ductal carcinoma in situ(DCIS). Methods We collected 26 DCIS patients treated in the Clinical Medical College of Guiyang Medical University from July 2009 to September 2014, and examined them using MG, CDUS and MRI methods respectively. The diagnose accuracy of those imaging methods were compared by Kruskal-Wallis test. Results There were calcification(73%, 19/26), structural disorder(36%, 8/26), and nodule(30%, 7/26) in the MG appearance of DCIS, and the dense microcalcification was remarkably performed(70%, 18/26). CDUS had performances like nodule(85%, 22/26), ductal ectasia(11.5%, 3/26), and low echo-level nodule without capsular was typical performance(59%, 13/22). Non-mass like enhancement was typical performance in enhanced MRI(73%, 19/26), most of TIC curves appeared as Ⅱand Ⅲ types(73%, 19/26). The accuracy of MG，CDUS and MRI imaging were 77%，50% and 85%, respectively. The accuracy could rise to 85% when both MG and CDUS were combined and 96% when the three methods were combined simultaneously(P＜0.05). Conclusion DCIS could be predicted by MG, CDUS, and MRI respectively, and all these three techniques have advantages and disadvantages, moreover, the combination of different imaging techniques could improve the predicting accuracy significantly.
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