| Objectives The purpose of this study is to provide a reasonable and valuable reference for clinical and female patients by comparing the application value of FFDM and MRI and their combination in the diagnosis of breast cancer in dense breast.Methods Retrospective case analysis,130 cases of qualified cases were collected as the subjects,and the 130 cases were judged by double-blind method according to the imaging characteristics of FFDM and MRI.the pathology was used as the gold standard,and the sensitivity,specificity,coincidence rate,positive predictive value,negative predictive value and Youden index of the FFDM,MRI and FFDM+MRI in the diagnosis of breast cancer in the dense breast were compared and analyzed.The diagnostic value of FFDM and MRI was compared according to different lesion size,and the diagnostic value of FFDM,MRI and FFDM+MRI was evaluated according to different age stratification.Results In 130 dense mammary glands,FFDM+MRI diagnosis sensitivity is 87.10%;as specific as MRI(78.79%);MRI sensitivity and specificity were higher than FFDM(54.84% > 48.39%,78.79% > 74.45%);FFDM+MRI diagnostic coincidence rate80.77%,73.08% higher than MRI,FFDM diagnostic coincidence rate was the lowest36.92%.The sensitivity and specificity of FFDM in three types were 58.33% and 76.36%,the Youden index was 0.35,the sensitivity and specificity of FFDM in 4A class were42.11%,72.73%,and the Youden index was 0.15.Conclusion FFDM in the dense type of breast three types of diagnostic efficacy is higher;The sensitivity and specificity of MRI in three types were 46.67%,78.26%,Youden 0.25,The sensitivity and specificity of MRI were 62.50% and 80.00% in the 4A classes,Youden index 0.43,The results show that MRI diagnosis efficiency of 4A in dense breast is higher;The sensitivity and specificity of FFDM+MRI in three types were 76.92% and 85.14%,Youden index 0.62,FFDM+MRI sensitivity,specificity 94.44%,60.00% in the 4A classes,Youden index 0.54,The results show that FFDM+MRI diagnosis of three and 4A in dense breast is equivalent,but higher than MRI and FFDM alone diagnostic efficacy.The diagnostic value of FFDM and MRI in benign and malignant lesions of dense breast is different,By statistical comparison,the difference was statistically significant(P < 0.05);FFDM was the most specific(58.33%)in > 5cm lesions,followed by 2cm-5cm(53.85%),then 1cm-2cm(50.00%)and finally in ≤1cm(44.44%);In ≤ 1cm lesions MRI sensitivity is as high as 85.71% > 66.67% of FFDM,and MRI sensitivity is 75.00% in 1cm-2cm lesions > 62.50% of FFDM,MRI sensitivity of57.14% in lesions from 2cm-5cm > 50.00% of FFDM,66.67% of MRI sensitivity in >5cm lesions > 60.00% of FFDM.Both methods in different lesions size MRI psychic density is higher than FFDM,MRI in ≤ 1cm lesions in the highest spirit density of 85.71%,Youden index of up to 0.39,it is concluded that MRI in dense breast different lesions size diagnosis of breast cancer than FFDM has advantages,in ≤ 1cm lesions MRI advantages are greater.After grouping by age,FFDM by age,P = 0.59,There is no significant difference;Joint MRI screening and radio MRI screening showed significant differences among different ages(P < 0.05).And in ≤ 40 years old,The lowest relative sensitivity,sensitivity was relatively high in patients aged 41-50 and > 50.FFDM sensitivity and specificity were61.54% and 64.15% in ≤ 40 years old,Youden index 0.26;Sensitivity and specificity were75.00% and 61.29% in 41-50 years old,Youden index 0.36;sensitivity and specificity were 83.33% and 53.33% in >50 years old patients,Youden index 0.37;Conclusion FFDM the greater the age of breast cancer diagnosis in dense breast,the higher the benefit.MRI sensitivity and specificity were 40.00% and 63.93% in ≤ 40 years old,Youden index 0.04;Sensitivity and specificity were 85.71% and 54.55% in patients aged 41-50,Youden index0.40;sensitivity and specificity were 80.00% and 68.75% in > 50 years old patients,Youden index 0.49;Conclusion MRI diagnosis of breast cancer in the dense breast the greater the benefit of the higher;FFDM+MRI sensitivity and specificity were 66.67% and73.33% in ≤ 40 years old,Youden index 0.40;FFDM+MRI sensitivity and specificity were75.00% and 56.52% in 41-50 years old,Youden index 0.32;Sensitivity and specificity were 60.00% and 68.75% in >50 patients aged,Youden index 0.29.FFDM+MRI sensitivity(66.67%)in ≤ 40 patients aged years was higher than that in FFDM and MRI alone(61.54% and 40.00%),The FFDM+MRI sensitivity(75.00%)of patients aged 41-50 years was lower or equal to that of FFDM and MRI alone(75.00% and 85.71%),FFDM+MRI sensitivity(60.00%)was lower in > 50 patients aged than in FFDM and MRI alone(83.33% and 80.00%).Conclusions The diagnostic efficacy of breast cancer in dense breast is FFDM+MRI better than that of MRI and FFDM,MRI than that in FFDM;The diagnostic efficacy of FFDM is higher in class 3 in dense breasts,the diagnostic efficiency of MRI is higher in class 4A in dense breast,and the diagnostic efficiency of FFDM+MRI in type 3 and class4 A in dense breasts is higher than that of individual diagnosis;MRI has advantages over FFDM in diagnosing breast cancer in different lesions of dense breasts,and MRI advantages are greater in ≤ 1cm lesions;FFDM and MRI in the diagnosis of dense breast cancer in the older the age,the higher the benefit,FFDM+MRI showed higher returns for diagnosing breast caner in patients with dense mammary glands ≤ 40 years of age.Figure24;Table9;Reference 81... |
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