X-ray Photography, Ultrasound And Mri Diagnostic Value Of Benign And Malignant Breast Lesions

Part1Comparison of mammography and color DopplerUltrasonography in diagnosis of early breast cancerABSTRACTObjective:1、 to explore the diagnostic value of mammography andcolor Doppler ultrasound and combination of qualitative in early breasttumor.2、 To study mammography describe mass "shape" sign in thediagnosis of tumor.3、To Identify of color Doppler ultrasound in blood flowresistance index (RI) value identification of breast benign, malignant lesions.Methods:1、 Collect the clinical data of63cases of female patients withbreast mass, routine to do the mammography and ultrasound (2D ultrasoundand color Doppler ultrasound) examination in preoperative surgical,excisionmasses were confirmed by pathology, including41cases with malignanttumors,22cases of benign tumors, two methods of examination results andthe two are combined the results were compared with pathology.2、63casesof focal shape, density, boundary, internal calcification were analyzed.3、Analysis and measurement of the lesions of63cases, measurement inside andaround the blood flow resistance index.Results: pathology: malignant tumor（41cases）, including infiltratingduct carcinoma（28cases）, invasive lobular carcinoma （8cases）, ductcarcinoma in situ（2cases）, medullar carcinoma（1cases）, invasive ductand lobular mixed carcinoma （2cases）. benign breast tumor（22cases）,including13cases,5cases of mammary gland fibroma,1case of lipoma,1cases of breast cysts,2cases of plasma cell mastitis.The sensitivity ofmammography in the diagnosis of malignant tumor for80.48%(33/41),Specific for63.64%(14/22). Accuracy for74,6%(47/63).The sensitivity forbreast ultrasound color Doppler in the diagnosis of malignant tumor for78.05%(32/41), Specific for72.72%(16/22). Accuracy for76.2%(48/63). United the two inspection methods for malignant tumor diagnosis insensitivity, specificity、 Accuracy is97.56%(40/41)、95.45%（21/22）、96.8%(61/63).2Mammography in the observation of tumor shape andboundary and inner micro calcification than ultrasound has advantages, and"shape" sign in the distinction between benign and malignant tumor hadstatistical significance (P<0.05), and color Doppler ultrasound blood flowresistance index (RI) of0.7to distinguish between benign and malignantlumps, which has significant significance (P<0.05).Conclusion: mammography and ultrasound alone for qualitative breasttumors was not statistically significant (P>0.05), but the combination of thetwo can improve the accurate rate of diagnosis, and has certaincomplementary. Part2Comparison of3.0T MRI and digital mammography and breastultrasound in the diagnosis of benign and malignant breastdiseasesObjective:1、to compare the value of conventional MRI and dynamiccontrast enhanced MRI in the diagnosis of breast lesions.2、Research ondynamic enhanced dynamic enhancement time intensity curve in differentialdiagnosis of breast benign and malignant lesions and meaning of MRI.3、toCompare and evaluate the significance of dynamic enhancement MRI andmammography combined breast ultrasound in differential diagnosis of breastmassesMethods: A total of80cases,76lesions. To do breast ultrasound,mammography two checks before operation, at the same time.then thediagnosis is not clear to do biopsy, clinical palpation are not satisfied, massesis not clear a walking routine breast MRI, dynamic enhanced MRI, andenhanced lesions drawing dynamic enhancement the time-intensity curve, andcompared with ultrasound and X-ray examination, all the mass routineresection of pathological and confirmed by pathology. Among32cases ofbenign, malignant in48cases.Results:1、pathologic findings:80cases,including48cases of malignanttumors patients, but only44lesions, including3cases of left breast cancerafter operation, no local recurrence, metastasis to the axillary lymph appeared,1cases without a primary focus, but the emergence of axillary lymph nodemetastasis, biopsy for consideration breast origin. In44cases, including24cases of infiltrating duct carcinoma, invasive lobular carcinoma in8cases,6cases of medullary carcinoma,4cases of carcinoma in situ,2cases of mixedcarcinoma.32cases of benign lesions, including14cases of hyperplasia ofbreast, fibroadenoma8cases,2cases of breast cysts,4cases of plasma cellmastitis,2cases of lipoma,2cases of intraductal papilloma.2、 dynamic enhanced MRI in the diagnosis of breast benign and malignant lesions,compared with the conventional MRI with high accuracy. Dynamic enhancedMRI in the diagnosis of malignant lesions of the sensitivity, specificity,accuracy, positive predictive value, and negative predictive value were90.9%(40/44),87.5%(28/32),89.4%(68/76),90.9%(40/44),87.5%(28/32).3、dynamic enhanced signal intensity time curve has a significant difference indifferential diagnosis of breast benign and malignant lesions,, there wasstatistical significance (P<0.05), can be used as an important index of dynamicenhanced MRI in the diagnosis of breast cancer.4、 combined examinationand dynamic enhanced MRI has obvious difference in malignant breast lesions,with statistical significance (P<0.05), no significant differences in benignbreast lesions, no statistical significance (P>0.05), dynamic enhanced MRI indiagnosis of the tumor is not clear, palpation is not satisfied, X-ray andultrasound difficult to detect in situ carcinoma small, breast cancer, occultbreast cancer, breast cancer postoperative monitoring with high accuracy rateof ultrasonography and x-ray.Conclusion: high accuracy of combination with mammography andbreast ultrasound for benign tumor, malignant, more suitable for breast diseasescreening, and difficult to determine for the first two examination methods inmalignant lesions needs further selection of dynamic contrast-enhanced MRIof the breast.