The Value Of Digital Mammography, Color Dopplor Ultrasonography And 3.0T MRI With Breast Lesions

Part 1 The diagnosis value of the breast lump' appearance and margin signs in benign and malignant lesions by the digital mammography X-rayObjective:To study the value of diagnosis of lump' appearance and margin signs in breast benign and malignant lesions by the digital mammography X-ray.Method:74 female breast lumb lesions confirmed by pathological diagnosis were from 19 to 80 years old with the mean age was 49.2y,36 cases were benign and 38 cases were malignant.We suggest that those breast lumps with deep lobulation sign and/or spiculation were belong to malignant appearance and margin signs group,and others(with neither deep lobulation sign nor spiculation) were belong to benign appearance and margin signs group.Result:By digital mammography X-ray imaging the breast lump' appearance and margin signs to diagnose the benign and malignant lesions,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 89.47%,91.67%,90.54%,91.89%,89.19%respectively.Taking 2cm as a boundary,It was no difference by using the benign and malignant breast lump' appearance and margin signs to diagnose benign and malignant breast lesion(p＞0.05).Taking 40 years old as a boundary,the malignant group:≥40y 89.47%,＜40y 10.52%.By using appearance and margin signs to diagnose the breast benign and malignant lumb lesions the accuracy were 76.92%,93.94%in≥40 years old group and 87.50%, 25.00%in＜40 years old group respectively,which was significant difference(p＜0.05).Conclusion:The appearance and margin signs could be taken as a referance to the qualitative diagnosis of benign and malignant breast lesions by digital mammography X-ray,which is simple and with large clinical value.Part 2 The diagnostic value in breastlumb lesions by digital mammography X-ray and color Dopplor ultrasonographyObjective:To evaluate the value of diagnosis in breast lumb lesions by digital mammography X-ray,color Dopplor ultrasonography and combination of both modalities.Methods:73 female breast lumb lesions confirmed by pathology were from 16 to 80 years old with the mean age was 47.3y,24 cases were benign and 49 cases were malignant lesions.All cases were diagnosed by mammography or ultrasonography or combine two methods and compared with the histological results.Result:To diagnose breast malignant lumb lesions,the sensitivity,specificity and accuracy rates were 89.80%,75.00% and 84.93%by mammography and 85.71%,83.33%and 84.93%by ultrasonography and 95.92%,91.67%and 94.52% by combine mammography and ultrasonography respectively. The accuracy to diagnose theⅠ,Ⅳtype breast lesions by ultrasonography was super than by mammography(P＜0.05), otherwise mammography inⅡ,Ⅲtype breast lesions was more accurate(62.50%vs 45.00%).Taking RI values≥0.7 as a boundary,there was significant difference(p＜0.05) between benign and maligant lesions.Conclusion:The accuracy of diagnosis the breast lumb lesions could be improved by combining digital mammograohy breast X-ray with color Doppler ultrasonography.Part 3 The qualitative value of 3.0T MRI and digital mammography X-ray for breast benign and malignant lesionsObjective:To compare the qualitative diagnosis value of 3.0T MRI and digital X-ray mammography for breast benign and malignant lesions,further discussion the advantage of 3.0T MRI for diagnosis of breast lesions.Methods:Retrospective analysis the image data of 187 cases of breast lesions patients,all patients were women,aged 16 to 80 years old,the average age of 47.8 years old.All patients have been confirmed by the needle or surgical pathology,78 cases of benign and 109 cases of malignant,all patients were examined by digital X-ray mammography,28 cases of those patients whose performance of mammography X-ray mammography were atypical further undergone MRI plain,dynamic contrast-enhanced scan and diffusion-weighted imaging,adoption variable sequences to diagnosis and analysis, and compared with the histological results.Result:The sensitivity,specificity and accuracy of 187 cases with digital X-ray mammography were 84.40%,82.05% and 83.42%.The sensitivity,specificity and accuracy of 28 cases with digital X-ray mammography and MRI were 57.14%, 71.43%,64.29%and 92.86%,85.71%,89.29%respectively.The accuracy of 28 cases with MRI and digital mammography X-ray had statistical significance(p＜0.01).187 cases of large sample and the number of molybdenum X-ray diagnosis of breast lesions compared with the accuracy of statistical significance (p＞0.05).Conclusion:Digital mammography X-ray examination is the basic breast imaging examination method,3.0T MRI because of the high soft tissue resolution,multi-parameter imaging,dynamic enhanced imaging and functional characteristics,towards the atypical cases of digital X-ray mammography,can be used as a further means of diagnosis.