Comparative Imaging Study On Breast Disease Using Mammography,Ultrasound And MRI

Objective:To investigate the value of mammography,ultrasound and MRI alone and different combinations in diagnosing breast diseases.Methods:210 patients of breast diseases with 252 lesions confirmed by pathology were retrospectively selected during May 2013 to October 2019 in our hospital.All patients underwent mammography,ultrasound and MRI examinations.All lesions were classified according to the breast imaging reporting and data system(BI-RADS)standard.To analyze the diagnostic sensitivities,specificities,accuracies,positive predictive values and negative predictive values of mammography,ultrasound,MRI and mammography+ultrasound,mammography+MRI,ultrasound+MRI,ultrasound+mammography+MRI in diagnosis of breast diseases.Results:The sensitivities of mammography,ultrasound and MRI alone and different combinations in diagnosis of breast cancers were all high,and the sensitivity of mammography+ultrasound was the highest.The differences of sensitivities between mammography+ultrasound and mammography,ultrasound were statistically significant(P<0.05),but the difference of sensitivity between mammography+ultrasound and MRI was not statistically significant(P>0.05).The sensitivity of MRI was slightly higher than those of mammography and ultrasound,but the differences between them were not statistically significant(P>0.05).The specificity and accuracy of MRI were significantly higher than those of mammography,ultrasound and mammography+ultrasound,and the differences were statistically significant(P<0.05),while the differences of specificities and accuracies between mammography,ultrasound and mammography+ultrasound were not statistically significant(P>0.05).The sensitivities,specificities and accuracies of mammography+MRI,ultrasound+MRI and mammography+ultrasound+MRI were not significantly different from MRI alone(P>0.05).The ROC curve showed that area under curve(AUC)of the mammography,ultrasound,MRI and mammography+ultrasound,mammography+MRI,ultrasound+MRI,ultrasound+mammography+MRI were 0.900,0.811,0.952,0.887,0.954,0.952 and 0.958 respectively.AUCMRI was significantly higher than AUCmammography,AUCultrasound and AUCmammography+ultrasound,and the differences were statistically significant(P<0.05).AUCmammography and AUCmanunography+ultrasound were higher than AUCultrasound,and the differences were statistically significant(P<0.05).while there was no significant difference between AUCmammogaphy+ultrasound and AUCmammography(P>0.05).There were no significant differences between AUCmanunography+MRI,AUCultrasound+MRI,AUCmaimmography+ultrasound+MRIand AUCMRI(P>0.05).Conclusion:MRI had high diagnostic efficiency for breast diseases,mammography and ultrasound had medium efficiencies,and the combination of the three examinations had the highest efficiency.The sensitivities of mammography and ultrasonic in diagnosis of breast cancers were high,but the specificities were low.Mammography combined with ultrasound could improve the diagnostic sensitivity,but could not improve the specificity.The sensitivity of mammography+ultrasound was similar to that of MRI,which could meet the needs of breast cancer screening and clinical diagnosis.While the diagnostic specificity and accuracy of MRI were significantly higher than those of mammography,ultrasound and mammography+ultrasound,and MRI had a good ability to distinguish benign and malignant breast lesions.Therefore,MRI could be used to improve the specificity and accuracy of mammography or ultrasound in diagnosis for difficult lesions.