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目的 :通过比较绝经前后女性致密型乳腺中乳腺癌的磁共振成像(magnetic resonance imaging,MRI)特征,探讨MRI对绝经前后女性致密型乳腺中乳腺癌的诊断价值。方法:318例符合要求的女性病例资料,由2名有经验的影像诊断医生依据乳腺影像报告数据系统(breast imaging-reporting and data system,BI-RADS)(2003版)标准进行盲法评判、分析。结果:318例中绝经前患者189例(59.43%),绝经后129例(40.57%);其中绝经前致密型乳腺96例(恶性54例,良性42例),绝经后致密型乳腺83例(恶性56例,良性27例)。绝经前不同乳腺类型中乳腺病变的良性与恶性所占构成比差异无统计学意义(P=0.219);而绝经后女性乳腺癌更常见于致密型乳腺(r=0.356,P<0.001)。MRI对绝经前、后致密性乳腺中乳腺癌的诊断准确度分别为75.93%和92.86%,两者差异具有统计学意义(χ~2=6.031,P=0.014)。结论:绝经后女性乳腺癌更常见于致密型乳腺;MRI可以作为绝经后致密型乳腺人群乳腺癌的有效筛查方法。
Objective: To compare the diagnostic value of magnetic resonance imaging (MRI) of breast cancer in the dense breast of women before and after menopause and to evaluate the value of MRI in the diagnosis of breast cancer in the dense breast of women before and after menopause. METHODS: A total of 318 eligible female case data were analyzed by two experienced imaging diagnosticians based on the BlI-RADS (2003 version) standard . Results: 189 cases (59.43%) were pre-menopausal patients in 318 cases, 129 cases (40.57%) were postmenopausal women, including 96 cases of premenopausal dense breast (54 cases of malignant and 42 cases of benign), 83 cases of postmenopausal dense breast 56 cases of malignant, benign in 27 cases). There was no significant difference in the proportions of benign and malignant breast lesions among different breast types in premenopausal women (P = 0.219). However, postmenopausal women with breast cancer were more common in dense breasts (r = 0.356, P <0.001). The accuracy of MRI in the diagnosis of breast cancer in premenopausal women and post-menopausal women was 75.93% and 92.86%, respectively, with statistical significance (χ ~ 2 = 6.031, P = 0.014). Conclusion: Breast cancer in postmenopausal women is more common in dense breasts. MRI can be used as an effective screening method for breast cancer in post-menopausal dense breasts.