标题：多模态超声联合核磁共振检查在乳腺肿瘤良、恶性鉴别诊断中的应用

      作者：陈瑛 1，马秀梅 2，贾爱华 3，冯彩霞 4，刘海龙 1    榆林市第一医院超声科 1、影像科 2、内分泌科 3、妇产科 4，陕西 榆林 719000

      卷次： 2021年32卷24期

      【摘要】 目的 分析多模态超声联合核磁共振(MRI)检查在乳腺良、恶性肿瘤鉴别诊断中的应用价值。方法 收集榆林市第一医院2019年7月至2020年12月收治的95例乳腺占位性病变患者的临床资料，分析乳腺良、恶性肿瘤影像学图像表现，以病理检查结果为金标准，计算多模态超声联合MRI鉴别诊断乳腺肿瘤良、恶性的效能。结果 95例乳腺占位性病变患者中良性病灶66例(69.47%)，恶性病灶29例(30.53%)；乳腺良性病灶的弹性系数和彩色多普勒(CDFI)评分明显低于乳腺恶性病灶，差异均具有统计学意义(P<0.05)；多模态超声、MRI检查和多模态超声联合MRI检查对乳腺病灶的检出率分别为83.16%，85.26%，96.84%，联合检查的检出率明显高于单一检查，差异均具有统计学意义(P<0.05)；多模态超声联合MRI检查鉴别诊断乳腺良、恶性病灶的敏感性、特异性及准确性分别为100.00%、95.45%、96.84%，均高于单一多模态超声(75.86%、86.36%、83.16%)和MRI检查(79.31%、87.88%、85.26%)，差异均具有统计学意义(P<0.05)，而多模态超声和MRI检查诊断效能比较差异无统计学意义(P>0.05)。结论 单一多模态超声、MRI检查均可有效诊断乳腺良、恶性疾病，两者联合可提高乳腺良、恶性疾病的敏感性、准确性。
      【关键词】 乳腺肿瘤；多模态超声；核磁共振；良性；恶性；鉴别诊断
      【中图分类号】 R737.9 【文献标识码】 A 【文章编号】 1003—6350（2021）24—3227—04

Application of multimodal ultrasound combined with magnetic resonance imaging in the differential diagnosis ofbenign and malignant breast tumors.
CHEN Ying 1, MA Xiu-mei 2, JIA Ai-hua 3, FENG Cai-xia 4, LIU Hai-long 1.Department of Ultrasound 1, Department of Imaging 2, Department of Endocrinology 3, Department of Obstetrics andGynecology 4, Yulin First Hospital, Yulin 719000, Shaanxi, CHINA
【Abstract】 Objective To analyze the application value of multimodal ultrasound combined with magnetic reso-nance imaging (MRI) in the differential diagnosis of benign and malignant breast tumors. Methods The clinical data of95 patients with space-occupying lesions of breast admitted to Yulin First Hospital from July 2019 to December 2020were collected, and the imaging manifestations of benign and malignant breast tumors were analyzed. The pathologicalexamination results were used as the gold standard to calculate the efficiency of multimodal ultrasound combined withMRI in the differential diagnosis of benign and malignant breast tumors. Results Among 95 patients with space-occu-pying lesions of breast, 66 (69.47%) had benign lesions and 29 (30.53%) had malignant lesions. The coefficient of elas-ticity and color Doppler Flow Imaging (CDFI) scores of benign breast lesions were significantly lower than those of ma-lignant breast lesions, and the difference was statistically significant (P<0.05). The detection rate of multimodal ultra-sound, MRI, and multimodal ultrasound combined with MRI were 83.16%, 85.26%, and 96.84%, respectively. The detec-tion rate of combined examination was significantly higher than that of single examination, and the difference was statis-tically significant (P<0.05). The sensitivity, specificity, and accuracy of multimodal ultrasound combined with MRI inthe differential diagnosis of benign and malignant breast lesions were 100.00% , 95.45% , and 96.84% , respectively,which were significantly higher than 75.86%, 86.36%, 83.16% of single multimodal ultrasound, and 79.31%, 87.88%,85.26% of MRI examination (P<0.05). There was no significant difference in the diagnostic efficiency between multi-modal ultrasound and MRI (P>0.05). Conclusion Single multimodal ultrasound and MRI can effectively diagnose be-nign and malignant breast diseases. The combination of the two can improve the sensitivity and accuracy of benign andmalignant breast diseases.
      【Key words】 Breast tumors; Multimodal ultrasound; MRI; Benign; Malignant; Differential diagnosis