本文選題：乳腺癌 + 術(shù)后復(fù)查　； 參考：《首都醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:本研究以病理和臨床為對照,探討磁共振成像技術(shù)在乳腺癌術(shù)后是否復(fù)發(fā)診斷及鑒別診斷價值,同時尋找判斷乳腺癌術(shù)后是否復(fù)發(fā)的最佳掃描序列。材料與方法:選取2010年1月-2016年12月期間在我院同時行乳腺癌術(shù)后MRI和超聲復(fù)查的女性患者52例(復(fù)查時患者平均年齡56.5歲,復(fù)查距手術(shù)平均時間為48.3個月)。以病理和臨床為對照,回顧性分析MRI、超聲兩種檢查方法在診斷乳腺癌是否復(fù)發(fā)時的敏感度、特異度,以及影像檢查結(jié)果與病理臨床結(jié)果的一致性;并分析不同MRI掃描序列在診斷乳腺癌術(shù)后是否復(fù)發(fā)中的價值。結(jié)果:52例患者中,MRI診斷為復(fù)發(fā)24例,經(jīng)手術(shù)病理證實(shí)23例,誤診一例,MRI診斷為瘢痕形成或未見復(fù)發(fā)29例,全部經(jīng)隨訪或手術(shù)證實(shí)無復(fù)發(fā)。超聲診斷為復(fù)發(fā)23例,其中5例經(jīng)隨訪無復(fù)發(fā),超聲診斷為無復(fù)發(fā)29例,其中5例漏診復(fù)發(fā)。MRI、超聲檢查的敏感度分別為100%、78.3%,特異度分別為96.5%、82.8%,準(zhǔn)確性分別為98.1%、80.8%。MRI與病理隨訪資料的一致性較好(MRI、超聲診斷kappa值分別為0.961、0.61)。MRI圖像中,動態(tài)增強(qiáng)早期出現(xiàn)強(qiáng)化病灶表現(xiàn)與乳腺癌復(fù)發(fā)的符合程度最高(kappa值為0.961)。結(jié)論:MRI在判斷乳腺癌術(shù)后復(fù)發(fā)和瘢痕中具有很高的準(zhǔn)確性,與臨床病理結(jié)果的一致性優(yōu)于超聲檢查,可以作為乳腺癌術(shù)后的常規(guī)檢查手段。同時,磁共振動態(tài)增強(qiáng)掃描對乳腺癌復(fù)發(fā)的檢出意義最大。
[Abstract]:Objective: to investigate the value of magnetic resonance imaging (MRI) in the diagnosis and differential diagnosis of postoperative recurrence of breast cancer, and to find out the best scan sequence for judging the recurrence of breast cancer. Materials and methods: from January 2010 to December 2016, 52 female patients with breast cancer underwent MRI and ultrasound examination simultaneously (mean age was 56.5 years), and the average time from reexamination to operation was 48.3 months. The sensitivity, specificity and consistency of MRI and ultrasonography in the diagnosis of breast cancer recurrence were analyzed retrospectively. The value of different MRI sequences in the diagnosis of postoperative recurrence of breast cancer was analyzed. Results among 52 cases, 24 cases were diagnosed as recurrence by MRI, 23 cases were proved by operation and pathology, 29 cases were diagnosed as scar formation or no recurrence by misdiagnosis by MRI. No recurrence was confirmed by follow-up or operation. Among the 23 cases diagnosed by ultrasound, 5 cases had no recurrence and 29 cases had no recurrence after follow up. Among them, the sensitivity of ultrasound examination was 100 and 78.3, the specificity was 96.5and 82.8, the accuracy was 98.1and 80.8.MRI was consistent with the pathological follow-up data. The kappa value of ultrasonography was 0.961and 0.61MRI, respectively, in MRI images, the sensitivity of ultrasonography was 78.3%, the specificity was 96.5% and 82.8%, and the accuracy was 98.1 and 80.8%, respectively. Dynamic contrast enhanced early enhanced lesions had the highest coincidence with breast cancer recurrence, and the kappa value was 0.961g. Conclusion Mr imaging has a high accuracy in judging the recurrence and scar of breast cancer after operation, and the consistency with clinicopathological results is superior to that of ultrasound, and it can be used as a routine examination method for breast cancer after operation. At the same time, dynamic contrast enhanced MRI is the most important in the detection of breast cancer recurrence.
【學(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.9;R445.2

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