论文部分内容阅读
目的:探讨乳腺MRI对乳腺恶性肿块切除术后残留病灶的诊断价值。方法:回顾性分析2009年9月-2012年9月肿块切除术后病理为恶性,需再次手术的患者共87例,再次手术前均行MRI,运用BI-RADS分类标准对MRI表现进行评估。结果:87例中28例(28/87)经病理证实为病灶残留。BI-RADS分类为Ⅱ类或Ⅲ类的共42例,4例病灶残留,其中21例患者行乳腺保乳手术;BI-RADS分类为Ⅳ类或Ⅴ类的共45例,24例病灶残留,其中4例的患者行乳腺保乳手术。MRI诊断残留病灶的灵敏度、特异度、阳性预测值、阴性预测值分别为85.7%、64.4%、53.3%和90.5%。MRI各种征象中导管样强化、节段性强化及结节样强化提示残留病灶的阳性预测值分别为77.8%、71.4%和54.5%。结论:MRI-BI-RADS分类标准有助于乳腺恶性肿块切除术后残留病灶的评估,导管样强化、节段性强化及结节样强化提示病灶残留。
Objective: To investigate the value of breast MRI in the diagnosis of residual lesions after resection of malignant breast tumor. Methods: A retrospective analysis of 87 patients with pathologically malignant and requiring reoperation after resection from September 2009 to September 2012 was performed. MRI was performed before reoperation and the MRI findings were evaluated using BI-RADS classification. Results: Of 87 cases, 28 cases (28/87) were pathologically confirmed as residual lesions. BI-RADS was classified as Class II or Class III in 42 cases, 4 cases were residual, of which 21 cases were breast-conserving surgery; BI-RADS were classified as Class IV or Class V in 45 cases, 24 cases were residual, 4 patients were breast-conserving surgery. The sensitivity, specificity, positive predictive value and negative predictive value of MRI in the diagnosis of residual lesions were 85.7%, 64.4%, 53.3% and 90.5% respectively. In all signs of MRI, catheter-like enhancement, segmental enhancement and nodular enhancement suggest that the positive predictive value of residual lesions were 77.8%, 71.4% and 54.5%, respectively. CONCLUSION: The MRI-BI-RADS classification is helpful for the evaluation of residual lesions after resection of breast neoplasms. Catheter-like enhancement, segmental enhancement and nodular enhancement suggest the residual lesions.