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【medical-news】在检出乳腺癌乳腺管内部分方面，
在检出乳腺癌乳腺管内部分方面，MRI优于CT
MRI is better than multislice CT for determining if and how far breast cancer has spread into the breast ducts, and it should be used before patients receive breast conserving therapy, according to a study in the August issue of the American Journal of Roentgenology.
在决定乳腺癌是否有乳腺管转移，以及转移的程度时，MRI优于多层螺旋CT，在局部切除手术前应该进行此项检查，美国放射学8月份报道。
Breast conserving therapy is prevalent for the treatment of early stage breast cancers. Among patients who receive such therapy, however, the overall survival rate is significantly lower when surgical margins are positive for tumor cells than when they are negative.
乳腺局部切除在早期乳腺癌的质量中应用十分普遍。但是接受此项手术的病人种，切除边缘肿瘤细胞检查阳性病人的总体生存率要低于阴性病人。
A positive surgical margin is usually the result of inadequate resection of the cancer's intraductal component. Accurate preoperative diagnosis of the intraductal component is therefore crucial to achieving a cancer-free surgical margin, according to the study.
切除边缘肿瘤细胞检查阳性是由于对乳腺癌乳腺管内部分切除不完全造成的。根据本报道，对乳腺癌乳腺馆内部分进行准确的术前评估是保证手术切除边缘肿瘤细胞检查阴性的关键。
Earlier studies that determined CT can accurately assess the extent of breast cancer are now being called into question because they compared single-slice spiral CT with 0.5T MRI. Some recent studies suggest that MSCT could be used to distinguish benign lesions from carcinomas, but these reports did not evaluate the extent of the involvement of intraductal components.
早期的研究结果认为CT能够准确评价乳腺癌的范围，如今这一结果收到质疑，因为早期的研究比较的是单层螺旋CT和0.5T的磁共振。最近的研究认为MSCT可以鉴别良性病变和癌症，但是这些研究都没有涉及肿瘤的乳腺管内部分。
Dr. Akiko Shimauchi, a graduate student at Tohoku University in Japan at the time of the study in AJR, and colleagues retrospectively reviewed reports of 69 patients with histologically proven invasive carcinoma who underwent MSCT and MRI. CT scans were performned on a LightSpeed Qx/i from GE Healthcare. MRI was performed using a 1.5T Magnetom Vision from Siemens Medical Solutions.
Akiko博士是日本Tohoku大学的毕业生，在AJR学习的时候，回顾性分析了组织病理学证实的69例进展期乳腺癌，都进行过MSCT和MRI检查。CT采用GE公司LightSpeed机型，MRI采用西门子Magnetom1.5T机器。
The 44 cases with intraductal component enhancement were classified into two morphologic types: ductal extension (34) and segmental distribution (10). The lengths of the main tumor and of the intraductal component were measured in cases with ductal extension. For cases with segmental distribution, only the maximum length of the tumor was measured.
显示乳腺管内部分增强的44例病人分为两种类型：乳腺管内延伸（34例）和节段性分布（10例）。对于具有乳腺管内部分的肿瘤测量肿瘤主体和乳腺管内部分的长度。对于节段性分布的肿瘤，仅仅测量肿瘤的最大经。
MRI correctly identified 33 of the 44 cases, while MSCT correctly identified 27. In six cases, MRI revealed an intraductal component but MSCT did not, but in no cases did MSCT reveal an intraductal component that was undetectable with MRI.
MRI准确现实44例病人中的33病人肿瘤的细节，而MSCT仅仅正确显示了27例病人的细节。在6例病人中，MRI显示了乳腺管内部分，但是MSCT没有显示。但是没有出现MSCT显示乳腺管内部分，而MRI不显示的情况。
The sensitivity, specificity, and accuracy in detecting the intraductal component were 61%, 88%, and 71%, respectively, using MSCT and 75%, 88%, and 80%, respectively, using MRI. The difference in sensitivity between MRI and CT was significant.
MSCT显示乳腺管内部分的敏感性、特异性、准确性分别为61%，88%，71%，而MRI为75%，88%，80%.MRI和CT的差异非常明显。
Underestimation of the length of the intraductal components by 15 mm or more was significantly less frequent with MRI (30%) compared with MSCT (55%).
测量乳腺管内部分的长度小于实际情况的15mm的情况，MRI（30%）明显少于MSCT（55%）.
No significant difference between MSCT and MRI occurred in the evaluation of the maximum length of tumors in cases with segmental distribution, which had relatively large intraductal components.
在节段性分布的病例中，MSCT与MRI没有显著性差异，因为这种情况下乳腺管内部分相对要大得多。
"In our institution, surgeons err on the side of caution by using a surgical margin that is 20 mm outside the radiologically determined tumor margin," Shimauchi said.
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作者:admin@医学,生命科学 2011-02-05 13:55
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