论文部分内容阅读
目的:探讨经乳腺专用磁共振成像(DBMRI)诊断为BI-RADS 4类病灶中的良恶性比例,并分析其误诊原因。方法:收集我院经DBMRI诊断为BI-RADS 4类的781例患者的资料,参照美国放射学BI-RADS分类标准,结合我院临床经验,认为形态学及血流动力学两项指标,一项表现为非良性,则将病灶归为BI-RADS 4类。以病理结果作为金标准,分析诊断为BI-RADS 4类病灶中的良恶性比例及“误诊”原因。结果:DBMRI诊断的781例患者的781个BI-RADS 4类病灶(BI-RADS 4A类301个,BI-RADS 4B类226个,BI-RADS 4C类254个),病理结果均提示异常,检测灵敏度达100%。其中,病理证实为良性的病灶共457个,恶性病灶共324个。DBMRI考虑为良性(BI-RADS 4A类),而病理结果为恶性的病灶(27个)主要为浸润性导管癌(37.04%)和导管原位癌(33.33%);DBMRI考虑为恶性(BI-RADS 4B、4C类),而病理结果为良性的病灶(457个)主要为纤维腺瘤(32.24%)、乳腺腺病(27.87%)及导管内乳头状瘤(25.68%)。结论:DBMRI因其较高的空间分辨率及高对比度,能为临床BI-RADS 4类亚分类病灶的不同处理提供依据。然而DBMRI仍存在其局限性,对于非肿块样病灶性质的判定仍较困难。建议非肿块样强化病灶,一定要结合乳腺X线及超声检查,提高其诊断准确率。
Objective: To investigate the proportion of benign and malignant lesions in the four types of BI-RADS diagnosed by breast magnetic resonance imaging (DBMRI) and analyze the causes of misdiagnosis. Methods: The data of 781 patients diagnosed as BI-RADS in our hospital by DBMRI were collected. According to the American Radiology BI-RADS classification standard and the clinical experience in our hospital, morphological and hemodynamic indexes Non-benign items, the lesions classified as BI-RADS 4 categories. The pathological results as the gold standard, analysis and diagnosis of BI-RADS 4 lesions in the proportion of benign and malignant and “misdiagnosis” causes. Results: Among the 781 patients diagnosed by DBMRI, there were 781 lesions of BI-RADS category 4 (301 in the BI-RADS category 4A, 226 in the BI-RADS category 4B, and 254 in the BI-RADS category 4C). All the pathological findings were abnormal. Sensitivity of 100%. Among them, 457 pathologically confirmed benign lesions and 324 malignant lesions. DBMRI considered benign (BI-RADS category 4A), and pathological findings were malignant (27 lesions) were mainly invasive ductal carcinoma (37.04%) and ductal carcinoma in situ (33.33%); RADS 4B and 4C). The pathologically benign lesions (457) were mainly fibroadenoma (32.24%), breast adenosis (27.87%) and intraductal papilloma (25.68%). Conclusion: Because of its high spatial resolution and high contrast ratio, DBMRI can provide the basis for the different treatment of CL-RADS Class 4 sub-classification lesions. However, DBMRI still has its limitations, and it is still difficult to judge the nature of non-mass-like lesions. Proposed non-lump-like enhancement of the lesion, must be combined with mammography and ultrasound to improve the diagnostic accuracy.