A Comparative Study Of X-ray Mammography, Ultrasound And MRI In The Evaluation Of Breast Masses

ObjectiveA comparative analysis of X-ray mammography, ultrasound and MRI imaging diagnostic accuracy of breast masses.Materials and MethodsA retrospective analysis of patients with breast masses from January 2013 to January 2015 at the Second Hospital of Shandong University, diagnosis and treatment, the X-ray mammography and ultrasound found it difficult to characterize breast lesions or clinical suspicion of breast disease, X-ray mammography and ultrasound present negative, MRI imaging in the preoperative accepted 51 patients were detected in tumors 53. All the patients were female,17-55 years old.The sonographic to mass, calcification, the tumor interior and surrounding blood flow signal are observed indicators; in the mammography X-ray examination, lumps and calcification are observed indicators; in the MRI, tumor morphology, boundary and dynamic enhancement curves are the observed indicators. All cases are based on the American College of Radiology to develop a "Breast Imaging Reporting and Data System (BI-RADS)" in mammography, ultrasound and MRI grading standards, The final diagnosis are depend on pathology which as the gold standard. Form the basis of breast parenchyma BI-RADS classification:a:almost entirely fat; b:scattered fibroglandular tissue; c:heterogeneous fibroglandular tissue; d:extreme fibroglandular tissue. This study divides breast glandular dense type and non-dense. Dense glandular type includes heterogeneous fibroglandular tissue and extreme fibroglandular tissue; non-dense type includes almost entirely fat and scattered fibroglandular tissue classes.Comparison of breast ultrasound, X-ray mammography, breast MRO, and three methods combined with the diagnosis of breast lumps accuracy, sensitivity, specificity, and the misdiagnosis rate differences. Comparing the detection rate of three examine methods for clinical untouched lesions. And a comparative study of diagnosis difference and efficiency of various inspection methods for dense and non-dense breast lesions.Results51 patients were detected 53 lesions,27 benign lesions; 26 malignant lesions. Pathological types include:invasive ductal carcinoma 17; intraductal carcinoma in situ 7; invasive lobular carcinoma 1; mucinous carcinoma 1; fibroadenoma 16; sclerosing adenosis 5; 3 intraductal papillomas; lobular mastitis 2; 1 breast tuberculosis.X-ray mammography, ultrasound and MR diagnostic accuracy was 60.38%, 58.49%,83.02%,; sensitivity was 66.67%,61.11%,90.48%; specificity were 57.89%, 57.14%,78.13%; positive predictive values were 38.46%,42.31%,73.08%; negative predictive values were 81.48%,74.07%,92.59%; missed diagnosis rate was 33.33%, 38.89%,9.52%; misdiagnosis rate was 42.11%,42.86%,21.87%. X-ray mammography, ultrasound examination of breast lesions alone diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive values were lower than the MRI examination, the difference was statistically significant (P<0.05). MRI and X-ray mammography, ultrasound contrast AUC difference had statistically significant (u= 3.75, P= 0.001<0.05; u= 3.50, P= 0.001<0.05); X-ray mammography and ultrasound difference was not statistically significant (u= 0.11, P = 0.456> 0.05).Pathological diagnosis confirmed in 53 lesions there are 17 physical untouched lesions. Mammography X-ray examination showed no lesions 12; ultrasonography showed negative 9; MRI lesions not detected two. No X-ray mammography and ultrasound diagnosis correct number of significant difference (P> 0.05); MR diagnosis right number is significantly higher than X-ray mammography and ultrasound examination alone (P<0.05).In 51 patients, there are 30 cases (58.8%) of dense glands,21 cases (41.2%) of non-compact type glands. X-ray mammography in the diagnosis of non-dense glandular lesions of sensitivity, specificity and accuracy were significantly higher than dense glandular disease (P<0.05); ultrasound examination of dense breast lesion diagnosis sensitivity, specificity and accuracy higher than mammography X-ray examination, the difference was statistically significant (P<0.05); no non-dense gland lesions diagnostic efficacy of ultrasound and X-ray mammography significant difference (P> 0.05); MRI examination of the effectiveness of different types of glandular lesions were significantly higher than the other two checks (P<0.05)ConclusionMammography, ultrasound and MRI three examine methods, each with advantages and disadvantages, for X-ray mammography and ultrasound found it difficult to characterize breast lesions or clinical suspicion of disease but breast X-ray mammography and ultrasound present negative, MRI examine can help to improve the diagnosis of breast masses.