超声弹性成像和99mTc-MIBI核素显像对乳腺癌诊断的价值比较

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目的寻找灵敏、特异、无创的诊断乳腺癌方法 ,比较99mTc-MIBI核素显像与超声检查对诊断乳腺肿瘤的临床价值。方法用二维超声检查的方法观察乳腺肿块,初步判断肿块的良恶性。对这些病例患者,选取76例患者在用超声进行弹性成像,根据弹性值进一步判断肿块良恶性。再用99mTc-MI-BI对76例乳腺肿块患者进行乳腺平面显像,采用早期及延迟二时相。观察肿块及淋巴结部位有无放射性浓聚。全部病例有手术病理对照。结果对乳腺肿块患者,76例患者术后病理证实37例为乳腺癌,观察超声弹性成像对肿块的判断:阳性例数36例,假阳性例数4例,假阴性例数5例,误诊率12%。其灵敏度为81%,特异性88%。观察其99mTc-MIBI显像结果 ,99mTc-MIBI显像乳腺癌阳例数29例,2例假阳性,10例假阴性,误诊率16%。其灵敏度为73%,特异性84%。结论超声弹性成像与99mTc-MIBI乳腺显像对比超声弹性成像对鉴别诊断乳腺肿块的良、恶性具有较高敏感性和准确性,可明显减少对乳腺癌的漏诊。 Objective To search for a sensitive, specific and noninvasive method for the diagnosis of breast cancer and to compare the clinical value of 99mTc-MIBI radionuclide imaging and ultrasonography in the diagnosis of breast cancer. Methods Two-dimensional ultrasonography was used to observe the breast mass and to determine the benign and malignant masses. Of these patients, 76 patients were selected for elastography with ultrasound and further for the benign and malignant masses based on their elastic values. 76 cases of breast masses were further examined by 99mTc-MI-BI. The early and delayed two-phase imaging was performed. Observe the tumor and lymph nodes with or without radioactive concentration. All cases have surgical pathology control. Results Of the 76 breast cancer patients, 37 cases were diagnosed as breast cancer by pathological examination. The sonography was used to evaluate the mass of the tumor. There were 36 positive cases, 4 false positive cases and 5 false negative cases. The misdiagnosis rate 12%. Its sensitivity is 81%, specificity 88%. The results of 99m Tc-MIBI imaging were 99mTc-MIBI positive cases of breast cancer in 29 cases, 2 false positives and 10 false negatives, the misdiagnosis rate was 16%. Its sensitivity is 73%, specificity 84%. Conclusion Compared with 99mTc-MIBI breast imaging, ultrasound elastography is more sensitive and accurate in differential diagnosis of benign and malignant breast masses, which can significantly reduce the missed diagnosis of breast cancer.
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