| Background: The incidence of breast cancer become more frequent,early diagnoses and early treatments are effective measures to reduce mortality and improve quality of life.There are many imaging examinations,which are mammography,ultrasound,MRI and CT for the diagnosis of breast cancer,and whose selection and application has important clinical significance for the clinical diagnosis,preoperative evaluation and the establishment of the treatment plan.Objectives: By observing and analyzing the signs of early breast cancer in the MRI,X-ray,ultrasound and CT,we determine the detection rate and imaging features and discuss the relationship between imaging signs and pathology,in order to improve the diagnosis accuracy of medical imaging.Methods: The imaging data of 224 patients(130 cases in left and 96 cases in right)with primary breast cancer(confirmed by surgery and pathology)were retrospectively reviewed in our hospital from Oct.31,2016 to Oct.1,2012,aged from 24 to 81(49.97±9.06),the lesions of maximum diameter was 6 ~ 30 ?(20.46±5.79 ?).All of the patients had examined in MRI,mammography,high-frequency ultrasound or CT.To observe MRI,X-ray mammography,high-frequency ultrasound and CT imaging findings,and compared with surgical pathology results.?2 test analysis and one-way ANOVA were used for data statistical analysis,using P<0.05 indicated statistical significance.Results: 1.Detection rate of imaging about early breast cancer 134 cases lesions were detected by MRI and the detection rate was 97.81%.171 cases were detected by mammography and the detection rate was 83.01%.170 cases were detected by High frequency ultrasound detection and detection rate was 86.73%.181 cases were detected by high frequency ultrasonography combined X-ray mammography and the detection rate was 95.58%.109 cases were detected by high frequency ultrasonography combined MRI and the detection rate was 99.09%.The detection rate which MRI combination with mammography,MRI combined mammography and high-frequency ultrasound were 100%.2.Image feature of early breast cancer 137 cases were examined by MRI which 125 cases lump form in leaf and irregularity(accounted for 91.24%)and 119 cases in edge burr and untidy(accounting for 86.86%).39 cases(28.46%)were even strengthening,49 cases(35.77%)were uneven strengthening and 49 cases(35.77%)contained areas of necrosis after dynamic enhancement.The TIC type was type II accounting for 83 cases(60.58%).206 cases were examined by mammography for 100 cases(48.54%)of lumps,65 cases(31.55%)of lumps and calcification,12 cases(5.83%)of signal calcification,19 cases(9.22%)of asymmetric density and structure disorder,10 cases(4.85%)did not see apparently abnormal.196 cases were examined by ultrasonic.168 cases(87.71%)with nonhomogeneous echo,106 cases(54.08%)with calcium deposition;58 cases(29.59%)had distinct boundary,while 138 cases(70.41%)had obscure boundary as ”crab”.21 cases(10.71%)had posterior echo attenuation and 124 cases(63.27%)were hypervascular.161 cases were examined by CT.In CT scan,the mean of CT value was(42.55±10.22)Hu.After enhancement of CT scan,95.03% cases were in delayed reinforcement and the mean of CT value was(85.93±17.85)Hu.120 cases(74.50%)were in irregular form,124 cases(77.00%)were in untidy edge,115 cases(71.40%)were in nonhomogeneous density and only 18 cases(11.20%)were in calcification.3.Relationship between the imaging signs and pathology of early breast cancer The difference of the maximum diameter of lesions has statistically significant between histological grade level I(the mean is 15.83±7.57 ?)and level III(the mean is 21.18±5.46 ?),genotyping type Luminal A(the mean is 18.57±6.59 ?)and Her2+(the mean is 23.21±4.64 ?)(P<0.05).Different genotyping MRI manifestations in its strengthening internal signal characteristics are more likely to show uneven,necrosis,and in TIC curve types are more likely to be platform,flow type than inflows type(P<0.05).There were no statistical significance among different parameter of MRI about pathological grading of the breast cancer lesions(P>0.05).In addition to the ductal carcinoma in situ,the other pathological types is given priority to be lump and mass with calcification performance in mammography features among different pathological type(P<0.05).There were no statistically significance among the features of mammography in different pathological grading and genotyping(P>0.05).The echo of the infiltrating ductal carcinoma is more uneven,and the echo of the invasive lobular carcinoma and ductal carcinoma in situ can be even and be not uneven among different pathological type ultrasonic echoes(P<0.05).There were no statistically significance among the performances of ultrasound imaging in different pathological grading,genotyping(P>0.05).The form of early breast in CT is regular lesion in histological grading?,rather than in grading ?,? in different histological class and is more like to be regular in genotyping type Luminal A,rather than other types(P<0.05).There were statistically significance between the increasing strengthen of CT value in Luminal A type(the average is 48.27± 20.90 Hu),Her2 + type(the average is 48.67 ±22.84 Hu)and in Triple Negative type(the mean is 30.60±8.46Hu)(P<0.05).Conclusion: 1.MRI has the highest detection rate in breast cancer.MRI combined with mammography and Ultrasonic can effectively improve the diagnostic accuracy.2.The largest lesion of early breast cancer is in histological grading III and genotyping type Her2+.The minimum lesion of early breast cancer is in histological grading I and genotyping type Luminal A.3.MRI after enhancement has more meaningful in early breast cancer,and it can be seen in uneven internal signal with necrosis easily,the type II and III of TIC.4.The form of lump and mass with calcification can be seen in early infiltrating ductal carcinoma in mammography,and the form of lump less can be seen in ductal carcinoma in situ.There will appear negative performance in mammography because of the gland density.5.Ultrasound shows the lesion with less effect by breast gland density.The lesions can be seen in low and uneven echo in early infiltrating ductal carcinoma,and their edge and the blood supply will be helpful to the diagnosis.6.CT shows the early breast with irregular lesion,focal enhancements are more in the types of Her2+ and Luminal A than in type of Triple Negative. |
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