微创医学

目的探讨多层螺旋CT（MSCT）与动态增强磁共振成像（DCE-MRI）在乳腺癌腋窝淋巴结转移术前评估中的应用价值。方法选择92例乳腺癌患者，均进行MSCT与DCE-MRI检查。将病理检查结果作为“金标准”，分析MSCT、DCE-MRI诊断乳腺癌腋窝淋巴结转移的应用价值，并计算MSCT、DCE-MRI诊断结果与病理检查结果的一致性。结果术后病理检查结果显示，92例乳腺癌患者中检出58例腋窝淋巴结转移，占比63.04%（58/92）；DCE-MRI诊断乳腺癌腋窝淋巴结转移的特异度（91.18%）、准确度（92.39%）、阳性预测值（94.74%）均高于MSCT（61.76%、76.09%、79.03%，均P＜0.05）；DCE-MRI诊断乳腺癌腋窝淋巴结转移的灵敏度（93.10%）、阴性预测值（88.57%）与MSCT检查（84.48%、70.00%）相比，差异均无统计学意义（均P＞0.05）。DCE-MRI诊断乳腺癌腋窝淋巴结转移与病理检查结果的一致性极好（Kappa值=0.838），MSCT诊断乳腺癌腋窝淋巴结转移与病理检查结果的一致性较理想（Kappa值=0.474）。结论乳腺癌腋窝淋巴结转移术前评估中使用MSCT、DCE-MRI诊断灵敏度均较高，可清晰显示病变情况，而DCE-MRI准确度及特异度均高于MSCT，与病理检查结果具有极高的一致性，应用价值更高。

ObjectiveTo investigate the application value of multi-slice spiral CT (MSCT) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in preoperative evaluation of axillary lymph node metastasis of breast cancer. MethodsA total of 92 patients with breast cancer were selected and examined by MSCT and DCE-MRI. The pathological examination result were taken as the “gold standard” to analyze the application value of MSCT and DCE-MRI on the diagnosis of axillary lymph node metastasis of breast cancer, and the consistency between the diagnostic results of MSCT and pathological examination results as well as the consistency between DCE-MRI diagnosis results and pathological examination results were calculated. ResultsPostoperative pathological examination results showed 58 cases of axillary lymph node metastasis in 92 breast cancer patients, accounting for 63.04% (58/92). The specificity (91.18%), accuracy (92.39%) and positive predictive value (94.74%) of DCE-MRI in the diagnosis of axillary lymph node metastasis of breast cancer were higher than those of MSCT (61.76%, 76.09%, 79.03%, all P＜0.05). The sensitivity (93.10%) and negative predictive value (88.57%) of DCE-MRI in the diagnosis of axillary lymph node metastasis of breast cancer were not significantly different from those of MSCT (84.48%, 70.00%) (all P>0.05). The results of DCE-MRI in the diagnosis of axillary lymph node metastasis of breast cancer showed good consistency with pathological examination results (Kappa value =0.838), while the results of MSCT in the diagnosis of axillary lymph node metastasis of breast cancer showed excellent consistency with pathological examination results (Kappa value=0.474). ConclusionMSCT and DCE-MRI are both highly sensitive in the preoperative evaluation of axillary lymph node metastasis of breast cancer, which can clearly show the pathological changes. And DCE-MRI has higher accuracy and specificity than MSCT, which is highly consistent with pathological examination results and has higher application value.