| ObjectiveBy analyzing the characteristics of ultrasound(US)and MRI of breast intraductal papilloma(IDP),we summarized and compared the advantages and disadvantages of the two examination methods in the diagnosis of each type of lesion,as well as the common imaging signs and respective characteristics of the lesion in the two examination methods,so as to improve the image recognition and diagnosis level of breast IDP.MethodA total of 115 female patients with breast IDP diagnosed by pathology in our hospital from January 2013 to June 2021 were retrospectively selected,with a total of 130 lesions.All patients underwent breast ultrasound,plain magnetic resonance imaging,multi-phase dynamic enhanced scanning,and DWI before surgery.The color ultrasound was performed in an all-round way.According to the sonogram,it was divided into catheter dilation with intraductal nodules(type Ⅰ),cystic and solid nodules(type Ⅱ),simple catheter dilation(type Ⅲ),catheter dilation with distal catheter nodules(type Ⅳ),solid nodules(type Ⅴ),and sheet disorder(type Ⅵ).The location,shape,size,catheter dilation,internal and posterior echo,calcification The internal and peripheral blood flow characteristics were analyzed retrospectively.Then,the lesions were divided into two groups according to whether there was ductal dilatation or not.The lesions were comprehensively analyzed and compared between groups.After the completion of MRI scanning,according to the presence or absence of dilated catheter,nodule and enhancement mode,it can be divided into five types:dilated catheter with nodule,solid nodule,cystic solid nodule,non mass enhancement and simple catheter expansion.The MRI images of the lesions were analyzed,measured and recorded,including shape,edge,size,DWI signal intensity,apparent diffusion coefficient(ADC)value,early maximum enhancement rate,dynamic enhancement time signal curve(TIC curve)type,etc.According to whether the edge of the nodule is smooth or not,the nodule is divided into two groups:the edge of the nodule is smooth and the edge of the nodule is not smooth.In combination with various MRI indicators,a comparative analysis between the groups is carried out.At present,there is no specific classification standard for the sub classification of the four types of breast lesions in MRI.The imaging physicians in our hospital,based on their rich experience in the past,combined Fischer’s scoring method with ADC values or combined with dynamic enhanced scanning vascular signs,classify tumor like and non tumor like lesions respectively.The ultrasound and MRI images were analyzed and evaluated according to the BI-RADS grading standard.For breast IDP,BI-RADS3 and 4A lesions are classified as diagnostic coincidence.The detection rate and accuracy of the two methods were summarized.Summarize the detection rate and coincidence rate of each type of lesions in the two examination methods.The accuracy of each type of lesions in ultrasound and magnetic resonance imaging was compared and analyzed to summarize which type of lesions were better diagnosed by the two examination methods.Analyze and summarize the image features of the two inspection methods,and summarize the characteristics of each feature in the two inspection methods.SPSS21.0 statistical analysis software was used for data processing.Match data with x2Or t test,P<0.05 is statistically significant.Results1.There was no statistically significant difference in the detection rate and missed diagnosis rate between the two inspection methods(P=0.470),and there was no statistically significant difference in the accuracy rate and misdiagnosis rate(P=0.077).The diagnostic coincidence rates of five types of breast IDP were:type Ⅰ(97.56%),type Ⅱ(91.30%),type Ⅲ(76.92%),type Ⅳ(76.92%),type Ⅴ(78.57%)and type Ⅵ(50%).2.The diagnostic coincidence rate of six types of breast IDP ultrasound was:typeⅠ(97.56%),type Ⅱ(91.30%),type Ⅲ(76.92%),type Ⅳ(76.92%),type Ⅴ(78.57%),and type Ⅵ(50%).The diagnostic coincidence rates of five types of breast IDP were dilated catheter with nodule(88.89%),solid nodule(80.23%),cystic solid nodule(55%),non mass enhancement(50%)and simple catheter dilation(60%).3.The diagnostic coincidence rate of five types of breast IDP magnetic resonance imaging is respectively:expanded catheter with nodule(88.89%),solid nodule(80.23%),cystic and solid nodule(55%),non mass enhanced(50%),and simple catheter expansion(60%).4.Ultrasound type Ⅰ and Ⅳ were classified as catheter dilatation with nodule type.The accuracy and misdiagnosis rates of the two examination methods were compared for five types of lesions.The difference was statistically significant between cystic and solid nodule type(P=0.000)and simple catheter dilatation type(P=0.010).5.There were significant differences between the two methods in displaying catheter dilation(P=0.007),catheter dilation diameter(P=0.001)and calcification(P=0.000).6.Ultrasonography:Compared with the lesions in the group without catheter dilation,the maximum diameter of the lesions in the group with catheter dilation was statistically significant(P=0.025).7.MRI examination:The comparison results between the two groups showed that there was a statistically significant difference in BI-RADS grading(P=0.000).Conclusion1.The detection rate and accuracy of the two methods in breast IDP are similar.2.The accuracy rate of type I and type II ultrasound examination of breast IDP is higher than that of the other four types;MRI examination of breast IDP,dilatation of catheter with nodular type,has the highest accuracy.3.The accuracy rate of ultrasonic examination is higher for cystic solid nodule type and simple catheter dilation type.4.Ultrasonography can more intuitively display the dilated catheter,the nodules in the catheter and the blood flow distribution of the nodules.Most nodules have little blood supply.5.In ultrasonic examination,breast IDP without ductal dilation is generally larger than IDP with ductal dilation.6.Some breast IDPs with rough edges and nodules have MRI findings similar to breast cancer,and BI-RADS classification is high. |
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