【摘要】 目的 探讨核磁共振(MRI)联合多模态超声在乳腺肿瘤良恶性中的鉴别诊断效能。方法 选取92例女性乳腺占位性病变患者为研究对象。对所有患者施行MRI与多模态超声检查，以病理检查结果为“金标准”,探究MRI+多模态超声联合检查对诊断乳腺肿瘤良恶性的应用价值。结果 92例乳腺占位性病变患者经病理检查证实为恶性有31例(33.70%),良性有61例(66.30%);MRI联合多模态超声共检查出30例为恶性，MRI共检查出25例为恶性，而多模态超声共检查出23例为恶性；MRI联合多模态超声检查在鉴别诊断乳腺肿瘤良恶性的灵敏度[93.55%(29/31)]、准确度[96.74%(89/92)]、阴性预测值[96.77%(60/62)]高于MRI、多模态超声单独检查，差异有统计学意义(P<0.05);MRI、多模态超声单独及联合检查的特异度、阳性预测值相比，差异无统计学意义(P>0.05)。kappa检验显示：MRI联合多模态超声检查结果与“金标准”的一致性极好(kappa值=0.926,P=0.000);MRI与多模态超声单独检查与“金标准”的一致性较为理想(kappa值=0.636、0.642,P=0.000、0.000)。结论 MRI联合多模态超声鉴别诊断乳腺肿瘤良恶性的效果显著，可有效提高恶性肿瘤诊断灵敏度与准确度，临床应用价值较高，值得大力推行。更多还原

【Abstract】 Objective To explore the differential diagnostic efficacy of magnetic resonance imaging(MRI) combined with multimodal ultrasound in breast tumors.Methods 92 female patients with breast occupying lesions were selected as the research subjects.MRI and multimodal ultrasound were performed on all patients, with pathological examination results as the “gold standard” to explore the application effect of MRI+multimodal ultrasound combined examination for benign and malignant breast tumors.Results Among the 92 cases of breast occupying lesions, 31 cases(33.70%) were confirmed as malignant and 61 cases(66.30%) as benign by pathological examination; A total of 30 cases were diagnosed as malignant by MRI combined with multimodal ultrasound, 25 cases were diagnosed as malignant by MRI,and 23 cases were diagnosed as malignant by multimodal ultrasound; The sensitivity [93.55%(29/31)],accuracy [96.74%(89/92)],and negative predictive value [96.77%(60/62)] of MRI combined with multimodal ultrasound in the differential diagnosis of breast tumors were higher than those of MRI and multimodal ultrasound alone, with statistically significant differences(P<0.05);There was no statistically significant difference in the specificity and positive predictive value between MRI and multimodal ultrasound alone and in combination(P>0.05).The Kappa test showed excellent consistency between the results of MRI combined with multimodal ultrasound and the “gold standard”(Kappa value=0.926,P=0.000);The consistency between MRI and multimodal ultrasound alone and the “gold standard” was relatively ideal(kappa values=0.636,0.642,P=0.000,0.000).Conclusion The combination of MRI and multimodal ultrasound has a significant effect in the differential diagnosis of benign and malignant breast tumors, which can effectively improve the sensitivity and accuracy of malignant tumor diagnosis.It has high clinical application value and is worth vigorously promoting.更多还原