超声弹性成像及核磁共振成像对乳腺癌诊断价值的研究
|
摘要
背景
乳腺癌是女性最常见的恶性肿瘤之一,早期诊断早期治疗,有助于提高患者的生存率和生活质量。近年来,随着钼靶X线、二维超声(Ultrasonography ,US)、磁共振成像技术(magnetic resonance imaging ,MRI)的应用,乳腺癌在影像学早期诊断方面取得了长足的进步,这些方法在诊断乳腺癌方面临床价值得到公认,但仍然存在不足:钼靶X线显示钙化灶敏感,但对致密型乳腺的肿块检出率不高;二维US受操作者个人技术因素影响较大,敏感度、特异度有待进一步提高;MRI敏感度、特异度较高,但乳腺检查技术复杂、检查时间较长,病人的顺应性较差且对钙化灶不敏感。因此,寻找更为有效和准确且易于应用的乳腺诊断筛查技术,是我们努力的目标。超声弹性成像技术(ultrasonic elastography,UE)不仅能够发现肿块,而且可以检测肿块组织弹性,并根据弹性大小进行评分,实时确定肿块病变的良、恶性质。本研究通过前瞻性研究和回顾性分析,比较UE、US、MRI对乳腺癌的诊断效率,并与病理结果对照,以评估UE、US、MRI及联合应用在诊断乳腺癌方面的价值。
研究目的
1.前瞻性研究UE诊断乳腺癌的临床价值;
2.研究UE与MRI联合应用对提高乳腺癌诊断效率的可行性;
3.回顾性分析US、MRI及US和MRI联合应用对乳腺癌的诊断效率,作为判断UE临床价值的对照。
研究方法
1.选取2009年9月至2009年12月就诊于我院并接受手术的乳腺肿块患者,所有患者均在术前1周内分别接受US、UE和MRI检查,依据US影像学分析、UE的5分法和MRI相关指标,分别对肿物进行良、恶性判断。对照患者术后病理学检查结果,作为患者最终的诊断。统计分析三种诊断方法的敏感度、特异度、阳性预测值及阴性预测值,并与UE联合MRI进行比较,分析在乳腺癌诊断方面的准确性和一致性。
2.回顾性分析2009年1月～2010年1月间,在我院诊断为乳腺肿块,术前行US、MRI检查、并实施手术切除或穿刺活检的患者。以病理作为金标准,分析US、MRI、及两者联合诊断乳腺癌的敏感度、特异度、阳性预测值、阴性预测值,绘制每种方法诊断乳腺癌的ROC曲线,并计算曲线下面积。
研究结果
1.共纳入研究患者30例,30例乳腺病灶,患者平均年龄50±14.5岁,其中良性11例,恶性19例。
(1)US诊断乳腺良、恶性病灶的敏感度为84.2%,特异度是72.7%,阳性预测值为84.2%,阴性预测值为72.7%。UE诊断乳腺癌的敏感度为89.5%,特异度为81.8%,阳性预测值为89.5%,阴性预测值为81.8%。MRI诊断乳腺癌的敏感度为94.7%,特异度100%,阳性预测值100%,阴性预测值为96.7%。UE与MRI联合诊断乳腺癌的敏感度为100%,特异度是81.8%,阳性预测值是90.4%,阴性预测值为100%。
(2)三种诊断手段的比较:采用拟合性分析,三种方法与乳腺癌病理诊断一致性检验结果显示,US检查kappa系数为0.569(P=0.002),UE检查kappa系数为0.713(P<0.000),MRI的kappa系数为0.930(P<0.000);UE联合MRI的kappa系数为0.769(P<0.000)。
(3)US、UE、MRI、UE联合MRI在诊断乳腺癌方面的Youden指数分别为0.57、0.71、0.95、0.81;从Youden指数以及上述各种研究方法诊断乳腺癌的阳性预测值来看,单独采用MRI诊断乳腺癌的诊断价值最高,高于US、UE、UE和MRI联合检测。
(4)对30个乳腺病灶,以US、UE、MRI、UE联合MRI绘制ROC曲线,结果表明采用MRI诊断的ROC曲线下面积最高,明显高于US和UE,同时也高于UE和MRI联合检查。采用Hanley and McNeil非参数法比较各Az值,差异均具有统计学性意义。
2.符合回顾性研究设定条件者共71例,均为女性,年龄51.1±11.6岁。其中46例为乳腺癌,年龄53.2±11.4岁;病理示为良性病变者25例,年龄47.0±10.7岁。
(1)US对乳腺癌诊断的敏感度为87.0%,特异度64.0%,误诊率为36.0%,正确率为78.9%;MRI诊断癌的敏感度89.1%,特异度88.0%,误诊率为12.0%,正确率为88.7%。以上数据两组比较,MRI优于US,其中特异度存在明显差异。若将两种方法联合使用,特异度为88.0%,敏感度提高到95.7%,漏诊率降到4.3%,正确率为93.0%,与US方法比较有显著性差异,与MRI方法比较差异无统计学意义。
(2)比较三种方法ROC曲线下面积,US组为0.755,小于MRI组的0.886,最高为联合组0.918,提示,三组比较,联合方法优于MRI和US方法。
结论
1.乳腺癌较容易漏诊,疑难病例定性困难,诊断方法需要提高。
2.UE、US是乳腺肿瘤影像检查技术中敏感度较高的检查方法,结合肿瘤的形态学特点及弹性评分,对鉴别乳腺良恶性病变具有较高的临床应用价值。
3.UE和US联合可以有效提高乳腺癌诊断的敏感度,减少漏诊率。
4.UE和MRI联合应用于乳腺癌的高危人群的监测,有利于减少漏诊,早发现、早诊断乳腺癌,对临床治疗方案的选择及患者的预后具有重要的意义。
Background
Breast cancer is one of the most common malignancies of women, and only early diagnosis and early treatment can improve the survival rate and quality of life. Although in recent years, great progress has been made in the early diagnosis on breast cancer, such as the X ray mammography, Doppler ultrasound, and magnetic resonance imaging (MRI) technology, these methods also have misdiagnosis rate in certain circumstances. Therefore, how to find a diagnostic technique with higher effectiveness and accuracy is the critical issue we need to address. Ultrasonic elastography (UE) technology can not only find tumors, but also tell benign and malignant pathologies by detecting the flexibility and elasticity. In this study, we prospectively studied the effectiveness of US, UE and MRI on diagnosis of breast cancer, and by comparing to the pathologic diagnosis, we evaluated the value of US, UE, MRI and combination strategy into diagnosis on breast cancer.
Objective
1. To assess the value of US, UE and MRI in detecting breast mass and in identifying benign and malignant lesions of breast lumps; to figure out the difference among the three diagnostic methods in sensitivity,specificity and other aspects of the diagnosis.
2. To evaluate ultrasound elasticity imaging technique in combination with magnetic resonance imaging in detecting and diagnosing breast masses. ROC curve analysis was used to analyze the effectiveness of ultrasound elasticity imaging and MRI in telling the benign and malignant breast pathologies. And its consistency with pathological examination was analyzed.
3. Retrospective analysis of color Doppler ultrasound and MRI in early diagnosis of breast cancer.
Materials and Methods
1. All patients enrolled in the study with breast masses were undergone mass resection in our hospital, from November 2009 to December 2009. One week before surgery, all patients took the examination of ordinary two-dimensional ultrasound examination, ultrasound elasticity imaging and magnetic resonance imaging. According to general analysis of two-dimensional ultrasound imaging, ultrasound elasticity imaging method and MRI, we got a benign or malignant tumor diagnosis on breast lump. Then the results of postoperative pathologic examination were collected, as the final diagnosis. Statistical analysis were conducted to analyze sensitivity, specificity, and positive predictive value of three diagnostic methods, and especially, the accuracy of ultrasound elasticity imaging technique in combination with magnetic resonance imaging in diagnosis of breast cancer was assessed.
2. A retrospective study of 71 cases of breast cancer was conducted. These patients were all with detailed data on preoperative color Doppler ultrasound and MRI examination. The specificity, sensitivity, positive predictive value, and negative predictive value were analyzed and the ROC curves were drawn.
Results
1. 30 patients, with one solid lesions detected by conventional ultrasonography(us,including grey—scale sonography, CDFI and Doppler spectrum)and UE and thereafter underwent pathological assessments, were included in a respective study. Among them, the median age was 50 years, ranging from 20 to 75 years. There were 11 benign and 19 malignant lesions.
(1). The sensitivity,specificity, positive predictive value and negative predictive value of US diagnosis were 84.2%, 72.7%, 84.2% and 72.7%. The sensitivity, specificity, positive predictive value,negative predictive value of UE were 89.5%, 81.8%,89.5% and 81.8%.The UE score of benign lesions was significantly lower than that of malignant leisions (P<0.001); The sensitivity, specificity, positive predictive value,negative predictive value for MRI diagnosis were 94.7%, 100%, 100% and 96.7%; The sensitivity,specificity positive predictive value and negative predictive value of UE combined with MRI diagnosis were 100%, 81.8%, 90.4% and 100%.
(2). As to the analysis of the diagnostic results of US, UE or MRI, in contrast to the pathologic diagnosis, the results of K test showed that the kappa value between UE and pathologic results was 0.713(P<0.000); that between US and pathologic results was 0.569(P=0.002); that between MRI and pathologic results was 0.930(P<0.000); and that between UE combined with MRI and pathologic results was 0.769(P<0.000). So the results showed that the kappa value between MRI and pathologic was much higher than the other diagnosis methods.
(3).The Youden index of US, UE, MRI, UE combined with MRI were 0.57, 0.71, 0,92, 0.79, respectively. Based on the Youden index and positive predictive value, the data showed that diagnostic significance of MRI excelled US, UE or UE combined with MRI in diagnostic effectiveness.
(4). Taking pathologic diagnosis as the gold standard,ROC curves were obtained. The areas under the ROC curve(Az) were calculated to assess the performance of the different methods, including UE, US, MRI and UE combined with MRI.The Azs of US ,UE, MRI and UE combined with MRI were 0.785, 0.856, 0.974 and 0.909 respectively, and the differences between each otherwere significant (P<0.05).
2. From Janaury 2009 to December 2010,71 patients, with one solid lesions detected by conventional ultrasonography(us,including grey—scale sonography, CDFI and Doppler spectrum) and MRI, thereafter underwent pathological assessments, were included in a respective study. Among them, the median age was 53.2 years. There were 25 benign and 46 malignant lesions.
(1)Using improved elasticity scores (P<0.05), the sensitivity of the ultrasound and MRI were 87.0 %、89.1%, and the specifity were 64.0%、88.0 %, and further more, the accuracy of both examinations were 78.9%、88.7% respectively. The sensitivity of combined application can be improved to 95.7%,which was higher than the diagnosis of ultrasonic and MRI(P<0.05).
(2)Taking pathologic diagnosis as the gold standard,ROC curves were obtained. The areas under the ROC curve(Az) were calculated to assess the performance of the different methods, includingUS, MRI and US combined with MRI.The Azs of US , MRI and US combined with MRI were 0.755, 0.866 and 0.918 respectively, and the differences between each otherwere significant (P<0.05).
(3)Over 80% patients with adenosis of mammary may be diagnosied breast cancer by US.
Conclusion
1. US and UE were feasible methods with high sensitivity for the imageology examination of breast tumor. Combined with the morphologic characteristics and plastic score, US and UE were with high practical value on telling the benign and malignant pathologies of breast.
2. MRI was superior to US, UE with regard to sensitivity, specificity and consistency with pathological examination. So if condition allowed, MRI could be an important method for the diagnosis of breast carcer.
3. Combination of US and MRI can improve the sensitivity of diagnosis, but MRI alone may be with the highest effectiveness of diagnosis.
4. Combination of US and MRI, improving the diagnostic sensitivity, could reduce the rate of misdiagnosis.
5. Combination of UE and MRI, or the combination of US and MRI, can be used as a scanning method on the people who are with high risk to breast cancer. They can improve the early detection and diagnosis of breast cancer, and reduce the rate of misdiagnosis. So they are with great significances in selecting treating strategy and improving prognosis of the disease.
乳腺癌是女性最常见的恶性肿瘤之一,早期诊断早期治疗,有助于提高患者的生存率和生活质量。近年来,随着钼靶X线、二维超声(Ultrasonography ,US)、磁共振成像技术(magnetic resonance imaging ,MRI)的应用,乳腺癌在影像学早期诊断方面取得了长足的进步,这些方法在诊断乳腺癌方面临床价值得到公认,但仍然存在不足:钼靶X线显示钙化灶敏感,但对致密型乳腺的肿块检出率不高;二维US受操作者个人技术因素影响较大,敏感度、特异度有待进一步提高;MRI敏感度、特异度较高,但乳腺检查技术复杂、检查时间较长,病人的顺应性较差且对钙化灶不敏感。因此,寻找更为有效和准确且易于应用的乳腺诊断筛查技术,是我们努力的目标。超声弹性成像技术(ultrasonic elastography,UE)不仅能够发现肿块,而且可以检测肿块组织弹性,并根据弹性大小进行评分,实时确定肿块病变的良、恶性质。本研究通过前瞻性研究和回顾性分析,比较UE、US、MRI对乳腺癌的诊断效率,并与病理结果对照,以评估UE、US、MRI及联合应用在诊断乳腺癌方面的价值。
研究目的
1.前瞻性研究UE诊断乳腺癌的临床价值;
2.研究UE与MRI联合应用对提高乳腺癌诊断效率的可行性;
3.回顾性分析US、MRI及US和MRI联合应用对乳腺癌的诊断效率,作为判断UE临床价值的对照。
研究方法
1.选取2009年9月至2009年12月就诊于我院并接受手术的乳腺肿块患者,所有患者均在术前1周内分别接受US、UE和MRI检查,依据US影像学分析、UE的5分法和MRI相关指标,分别对肿物进行良、恶性判断。对照患者术后病理学检查结果,作为患者最终的诊断。统计分析三种诊断方法的敏感度、特异度、阳性预测值及阴性预测值,并与UE联合MRI进行比较,分析在乳腺癌诊断方面的准确性和一致性。
2.回顾性分析2009年1月～2010年1月间,在我院诊断为乳腺肿块,术前行US、MRI检查、并实施手术切除或穿刺活检的患者。以病理作为金标准,分析US、MRI、及两者联合诊断乳腺癌的敏感度、特异度、阳性预测值、阴性预测值,绘制每种方法诊断乳腺癌的ROC曲线,并计算曲线下面积。
研究结果
1.共纳入研究患者30例,30例乳腺病灶,患者平均年龄50±14.5岁,其中良性11例,恶性19例。
(1)US诊断乳腺良、恶性病灶的敏感度为84.2%,特异度是72.7%,阳性预测值为84.2%,阴性预测值为72.7%。UE诊断乳腺癌的敏感度为89.5%,特异度为81.8%,阳性预测值为89.5%,阴性预测值为81.8%。MRI诊断乳腺癌的敏感度为94.7%,特异度100%,阳性预测值100%,阴性预测值为96.7%。UE与MRI联合诊断乳腺癌的敏感度为100%,特异度是81.8%,阳性预测值是90.4%,阴性预测值为100%。
(2)三种诊断手段的比较:采用拟合性分析,三种方法与乳腺癌病理诊断一致性检验结果显示,US检查kappa系数为0.569(P=0.002),UE检查kappa系数为0.713(P<0.000),MRI的kappa系数为0.930(P<0.000);UE联合MRI的kappa系数为0.769(P<0.000)。
(3)US、UE、MRI、UE联合MRI在诊断乳腺癌方面的Youden指数分别为0.57、0.71、0.95、0.81;从Youden指数以及上述各种研究方法诊断乳腺癌的阳性预测值来看,单独采用MRI诊断乳腺癌的诊断价值最高,高于US、UE、UE和MRI联合检测。
(4)对30个乳腺病灶,以US、UE、MRI、UE联合MRI绘制ROC曲线,结果表明采用MRI诊断的ROC曲线下面积最高,明显高于US和UE,同时也高于UE和MRI联合检查。采用Hanley and McNeil非参数法比较各Az值,差异均具有统计学性意义。
2.符合回顾性研究设定条件者共71例,均为女性,年龄51.1±11.6岁。其中46例为乳腺癌,年龄53.2±11.4岁;病理示为良性病变者25例,年龄47.0±10.7岁。
(1)US对乳腺癌诊断的敏感度为87.0%,特异度64.0%,误诊率为36.0%,正确率为78.9%;MRI诊断癌的敏感度89.1%,特异度88.0%,误诊率为12.0%,正确率为88.7%。以上数据两组比较,MRI优于US,其中特异度存在明显差异。若将两种方法联合使用,特异度为88.0%,敏感度提高到95.7%,漏诊率降到4.3%,正确率为93.0%,与US方法比较有显著性差异,与MRI方法比较差异无统计学意义。
(2)比较三种方法ROC曲线下面积,US组为0.755,小于MRI组的0.886,最高为联合组0.918,提示,三组比较,联合方法优于MRI和US方法。
结论
1.乳腺癌较容易漏诊,疑难病例定性困难,诊断方法需要提高。
2.UE、US是乳腺肿瘤影像检查技术中敏感度较高的检查方法,结合肿瘤的形态学特点及弹性评分,对鉴别乳腺良恶性病变具有较高的临床应用价值。
3.UE和US联合可以有效提高乳腺癌诊断的敏感度,减少漏诊率。
4.UE和MRI联合应用于乳腺癌的高危人群的监测,有利于减少漏诊,早发现、早诊断乳腺癌,对临床治疗方案的选择及患者的预后具有重要的意义。
Background
Breast cancer is one of the most common malignancies of women, and only early diagnosis and early treatment can improve the survival rate and quality of life. Although in recent years, great progress has been made in the early diagnosis on breast cancer, such as the X ray mammography, Doppler ultrasound, and magnetic resonance imaging (MRI) technology, these methods also have misdiagnosis rate in certain circumstances. Therefore, how to find a diagnostic technique with higher effectiveness and accuracy is the critical issue we need to address. Ultrasonic elastography (UE) technology can not only find tumors, but also tell benign and malignant pathologies by detecting the flexibility and elasticity. In this study, we prospectively studied the effectiveness of US, UE and MRI on diagnosis of breast cancer, and by comparing to the pathologic diagnosis, we evaluated the value of US, UE, MRI and combination strategy into diagnosis on breast cancer.
Objective
1. To assess the value of US, UE and MRI in detecting breast mass and in identifying benign and malignant lesions of breast lumps; to figure out the difference among the three diagnostic methods in sensitivity,specificity and other aspects of the diagnosis.
2. To evaluate ultrasound elasticity imaging technique in combination with magnetic resonance imaging in detecting and diagnosing breast masses. ROC curve analysis was used to analyze the effectiveness of ultrasound elasticity imaging and MRI in telling the benign and malignant breast pathologies. And its consistency with pathological examination was analyzed.
3. Retrospective analysis of color Doppler ultrasound and MRI in early diagnosis of breast cancer.
Materials and Methods
1. All patients enrolled in the study with breast masses were undergone mass resection in our hospital, from November 2009 to December 2009. One week before surgery, all patients took the examination of ordinary two-dimensional ultrasound examination, ultrasound elasticity imaging and magnetic resonance imaging. According to general analysis of two-dimensional ultrasound imaging, ultrasound elasticity imaging method and MRI, we got a benign or malignant tumor diagnosis on breast lump. Then the results of postoperative pathologic examination were collected, as the final diagnosis. Statistical analysis were conducted to analyze sensitivity, specificity, and positive predictive value of three diagnostic methods, and especially, the accuracy of ultrasound elasticity imaging technique in combination with magnetic resonance imaging in diagnosis of breast cancer was assessed.
2. A retrospective study of 71 cases of breast cancer was conducted. These patients were all with detailed data on preoperative color Doppler ultrasound and MRI examination. The specificity, sensitivity, positive predictive value, and negative predictive value were analyzed and the ROC curves were drawn.
Results
1. 30 patients, with one solid lesions detected by conventional ultrasonography(us,including grey—scale sonography, CDFI and Doppler spectrum)and UE and thereafter underwent pathological assessments, were included in a respective study. Among them, the median age was 50 years, ranging from 20 to 75 years. There were 11 benign and 19 malignant lesions.
(1). The sensitivity,specificity, positive predictive value and negative predictive value of US diagnosis were 84.2%, 72.7%, 84.2% and 72.7%. The sensitivity, specificity, positive predictive value,negative predictive value of UE were 89.5%, 81.8%,89.5% and 81.8%.The UE score of benign lesions was significantly lower than that of malignant leisions (P<0.001); The sensitivity, specificity, positive predictive value,negative predictive value for MRI diagnosis were 94.7%, 100%, 100% and 96.7%; The sensitivity,specificity positive predictive value and negative predictive value of UE combined with MRI diagnosis were 100%, 81.8%, 90.4% and 100%.
(2). As to the analysis of the diagnostic results of US, UE or MRI, in contrast to the pathologic diagnosis, the results of K test showed that the kappa value between UE and pathologic results was 0.713(P<0.000); that between US and pathologic results was 0.569(P=0.002); that between MRI and pathologic results was 0.930(P<0.000); and that between UE combined with MRI and pathologic results was 0.769(P<0.000). So the results showed that the kappa value between MRI and pathologic was much higher than the other diagnosis methods.
(3).The Youden index of US, UE, MRI, UE combined with MRI were 0.57, 0.71, 0,92, 0.79, respectively. Based on the Youden index and positive predictive value, the data showed that diagnostic significance of MRI excelled US, UE or UE combined with MRI in diagnostic effectiveness.
(4). Taking pathologic diagnosis as the gold standard,ROC curves were obtained. The areas under the ROC curve(Az) were calculated to assess the performance of the different methods, including UE, US, MRI and UE combined with MRI.The Azs of US ,UE, MRI and UE combined with MRI were 0.785, 0.856, 0.974 and 0.909 respectively, and the differences between each otherwere significant (P<0.05).
2. From Janaury 2009 to December 2010,71 patients, with one solid lesions detected by conventional ultrasonography(us,including grey—scale sonography, CDFI and Doppler spectrum) and MRI, thereafter underwent pathological assessments, were included in a respective study. Among them, the median age was 53.2 years. There were 25 benign and 46 malignant lesions.
(1)Using improved elasticity scores (P<0.05), the sensitivity of the ultrasound and MRI were 87.0 %、89.1%, and the specifity were 64.0%、88.0 %, and further more, the accuracy of both examinations were 78.9%、88.7% respectively. The sensitivity of combined application can be improved to 95.7%,which was higher than the diagnosis of ultrasonic and MRI(P<0.05).
(2)Taking pathologic diagnosis as the gold standard,ROC curves were obtained. The areas under the ROC curve(Az) were calculated to assess the performance of the different methods, includingUS, MRI and US combined with MRI.The Azs of US , MRI and US combined with MRI were 0.755, 0.866 and 0.918 respectively, and the differences between each otherwere significant (P<0.05).
(3)Over 80% patients with adenosis of mammary may be diagnosied breast cancer by US.
Conclusion
1. US and UE were feasible methods with high sensitivity for the imageology examination of breast tumor. Combined with the morphologic characteristics and plastic score, US and UE were with high practical value on telling the benign and malignant pathologies of breast.
2. MRI was superior to US, UE with regard to sensitivity, specificity and consistency with pathological examination. So if condition allowed, MRI could be an important method for the diagnosis of breast carcer.
3. Combination of US and MRI can improve the sensitivity of diagnosis, but MRI alone may be with the highest effectiveness of diagnosis.
4. Combination of US and MRI, improving the diagnostic sensitivity, could reduce the rate of misdiagnosis.
5. Combination of UE and MRI, or the combination of US and MRI, can be used as a scanning method on the people who are with high risk to breast cancer. They can improve the early detection and diagnosis of breast cancer, and reduce the rate of misdiagnosis. So they are with great significances in selecting treating strategy and improving prognosis of the disease.
引文
1. Chen SC, Chen MF, Hwang TL, et al. Prediction of supraclavicular lymph node metastasis in breast carcinoma. Int J Radiat Oncol Biol Phys, Mar 1 2002,52(3):614-619
2.许红毛德强,王燕.重庆市女性肿瘤发病率及年龄特征分析.重庆医学,2010,39(11):2
3. Kok DL, Chang JH, Erbas B, et al. Urban-rural differences in the management of screen-detected invasive breast cancer and ductal carcinoma in situ in victoria. ANZ J Surg,2006,76(11):996-1001
4. Zorzi M, Puliti D, Vettorazzi M, et al. Mastectomy rates are decreasing in the era of service screening: a population-based study in Italy (1997-2001). Br J Cancer, 2006, 95(9):1265-1268
5.成克伦. 200例乳腺癌临床病理分析.中国妇幼保健, 2009, 24(26):2
6. Malik AM, Pathan R, Shaikh NA, et al. Pattern of presentation and management of ca breast in developing countries. There is a lot to do. J Pak Med Assoc, 2010, 60(9):718-721
7. Evans A, Whelehan P, Thomson K, et al. Quantitative shear wave ultrasound elastography: initial experience in solid breast masses. Breast Cancer Res, 2010,12(6):R104
8. Sariego J. Breast cancer in the young patient. Am Surg, 2010,76(12):1397-1400
9. Baker JA, Kornguth PJ, Soo MS, et al. Sonography of solid breast lesions: observer variability of lesion description and assessment. AJR Am J Roentgenol,1999,172(6):1621-1625
10. Kuba S, Ohtani H, Yamaguchi J, et al. Incomplete inside-out growth pattern in invasive breast carcinoma: association with lymph vessel invasion and recurrence-free survival. Virchows Arch., 2011,458(2):159-169
11.李朝明,郭永萍,李登维.乳腺钼靶X线摄影与数字化摄影.医用放射技术杂志,2005,14(7):2
12.岳建国.乳腺癌钼靶X线征象分析.实用放射学杂志,2008,24(9):2
13. Luini A, Gatti G, Brenelli F, et al. Male breast cancer in a young patient treated with nipple-sparing mastectomy: case report and review of the literature. Tumori,2007,93(1):118-120
14. Bharat A, Aft RL, Gao F, et al. Patient and tumor characteristics associated with increased mortality in young women (< or =40 years) with breast cancer. J Surg Oncol, 2009,100(3):248-251
15.史英琴满守东,杨光.50例乳腺实性肿块超声诊断分析.当代医学, 2010,114(19):2
16.张宇靖.超声诊断乳腺癌的价值.中国当代医学,2007,6(13):1
17. Katsinelos P, Stavros D, Pirpilidis I, et al. Unobstructed biliary tract dilatation in a patient with breast carcinoma and dermatomyositis: a new paraneoplastic manifestation? Am J Gastroenterol,1999,94(11):3383-3385
18. Son EJ, Kim EK, Kim JA, et al. Diagnostic value of 3D fast low-angle shot dynamic MRI of breast papillomas. Yonsei Med J, 2009,50(6):838-844
19. Cecil KM, Schnall MD, Siegelman ES, et al. The evaluation of human breast lesions with magnetic resonance imaging and proton magnetic resonance spectroscopy. Breast Cancer Res Treat, 2001, 68(1):45-54
20. Krishnamurthy S, Sneige N, Bedi DG, et al. Role of ultrasound-guided fine-needle aspiration of indeterminate and suspicious axillary lymph nodes in the initial staging of breast carcinoma. Cancer, 2002, 95(5):982-988
21. Kumar AS, Bhatia V, Henderson IC. Overdiagnosis and overtreatment of breast cancer: rates of ductal carcinoma in situ: a US perspective. Breast Cancer Res, 2005,7(6):271-275
22. Moon WK, Myung JS, Lee YJ, et al. US of ductal carcinoma in situ. Radiographics., 2002, 22(2):269-280
23. Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology, 2006, 239(2):341-350
24. Fowlkes JB, Emelianov SY, Pipe JG, et al. Magnetic-resonance imaging techniques for detection of elasticity variation. Med Phys, 1995, 22(11 Pt 1):1771-1778
25. Zhi H, Ou B, Luo BM, et al. Comparison of ultrasound elastography, mammography, and sonography in the diagnosis of solid breast lesions. J Ultrasound Med, 2007, 26(6):807-815
26.罗葆明,欧冰,冯霞,等.乳腺疾病实时组织弹性成像与病理对照的初步探讨.中国超声医学杂志, 2005, 21(9):3
27. Krouskop TA, Wheeler TM, Kallel F, et al. Elastic moduli of breast and prostate tissues under compression. Ultrason Imaging, 1998, 20(4):260-274
28. Hiltawsky KM, Kruger M, Starke C, et al. Freehand ultrasound elastography of breast lesions: clinical results. Ultrasound Med Biol, 2001, 27(11):1461-1469
29. Jiang J, Hall TJ. A generalized speckle tracking algorithm for ultrasonic strain imaging using dynamic programming. Ultrasound Med Biol, 2009, 35(11):1863-1879
30.王怡,王涌.组织弹性成像鉴别乳腺良恶性肿块的价值评估.中国医学影像技术, 2005,21(11):3
31. Thomas A, Fischer T, Frey H, et al. Real-time elastography--an advanced method of ultrasound: First results in 108 patients with breast lesions. Ultrasound Obstet Gynecol., 2006, 28(3):335-340
32. Orel S. Who should have breast magnetic resonance imaging evaluation? J Clin Oncol, 2008, 26(5):703-711
33.周景玮,陈克敏,刘林祥,等.乳腺疾病的MRI与钼钯诊断.现代医用影像学, 2006, 15(6):4
34. Kuhl CK, Bieling HB, Gieseke J, et al. Healthy premenopausal breast parenchyma in dynamic contrast-enhanced MR imaging of the breast: normal contrast medium enhancement and cyclical-phase dependency. Radiology, 1997, 203(1):137-144
35. Coulthard A, Potterton AJ. Pitfalls of breast MRI. Br J Radiol, 2000, 73(870):665-671
36. Houssami N, Morrow M. Pre-operative breast MRI in women with recently diagnosed breast cancer--where to next? Breast, 2010, 19(1):1-2
37. Pinto Pereira SM, Hipwell JH, McCormack VA, et al. Automated registration of diagnostic to prediagnostic x-ray mammograms: evaluation and comparison to radiologists' accuracy. Med Phys, 2010, 37(9):4530-4539
38. Lorenzen J, Wedel AK, Lisboa BW, Loning T, et al. [Diagnostic mammography and sonography: concordance of the breast imaging reporting assessments and final clinical outcome]. Rofo, 2005, 177(11):1545-1551
39. Wind JJ, Ammerman JM. Pathologic cervical burst fracture presenting with airway compromise. South Med J, 2010, 103(6):551-553
40. Warner E, Causer PA. MRI surveillance for hereditary breast-cancer risk. Lancet,2005, 365(9473):1747-1749
41. Weatherall PT, Evans GF, Metzger GJ, et al. MRI vs. histologic measurement of breast cancer following chemotherapy: comparison with x-ray mammography and palpation. J Magn Reson Imaging, 2001 ,13(6):868-875
42.刘黎明静国庆,李立军.数字化钼靶X线摄影对早期乳腺癌的诊断价值.西南军医, 2010, 12(4):2
43.吴树强赵朝华,李普查.超声、X线钼靶检查及两者联合应用对乳腺癌的诊断价值.现代肿瘤医学, 2010, 18(7):3
44. Wu F, Wang ZB, Chen WZ, et al. Extracorporeal focused ultrasound surgery for treatment of human solid carcinomas: early Chinese clinical experience. Ultrasound Med Biol, 2004, 30(2):245-260
45. Singh S, Pradhan S, Shukla RC, et al. Color Doppler ultrasound as an objective assessment tool for chemotherapeutic response in advanced breast cancer. Breast Cancer, 2005, 12(1):45-51
46. Orsi F, Zhang L, Arnone P, et al. High-intensity focused ultrasound ablation: effective and safe therapy for solid tumors in difficult locations. AJR Am J Roentgenol, 2010, 195(3):W245-252
47. Kang DK, Kim MJ, Jung YS, et al. Clinical application of multidetector row computed tomography in patient with breast cancer. J Comput Assist Tomogr. , 2008, 32(4):583-598
48. Uematsu T, Yuen S, Kasami M, et al. Comparison of magnetic resonance imaging, multidetector row computed tomography, ultrasonography, and mammography for tumor extension of breast cancer. Breast Cancer Res Treat, 2008, 112(3):461-474
49. Hikino H, Yasui K, Ozaki N, et al. Significance of preoperative lymphoscintigraphy and thin-slice computed tomography on sentinel node assessment: metastatic sentinel node in a lateral paramammary lesion out of axillary nodes from breast cancer. Radiat Med, 2006, 24(8):583-586
50. Fujita T, Doihara H, Takabatake D, et al. Multidetector row computed tomography for diagnosing intraductal extension of breast carcinoma. J Surg Oncol, 2005, 91(1):10-16
51. Erickson SJ, Godavarty A. Hand-held based near-infrared optical imaging devices: a review. Med Eng Phys, 2009, 31(5):495-509
52. Gershon D. Lobbyists prompt US breast cancer campaign. Nature, 1993, 366(6456):601
53. Hoffman RL. Thermography in the detection of breast malignancy. Am J Obstet Gynecol, 1967, 98(5):681-686
54.郑秀萍.红外热图对乳腺疾病的诊断与分析.实用医技杂志, 2009, 16(12):1
55. Kashima Y, Shimojima Y, Fukushima K, et al. Paraneoplastic neurologic syndrome associated with small breast cancer: diagnostic value of FDG-PET for detection of underlying malignancy. Intern Med, 2005, 44(5):522-523
56. Heinisch M, Gallowitsch HJ, Mikosch P, et al. Comparison of FDG-PET and dynamic contrast-enhanced MRI in the evaluation of suggestive breast lesions. Breast, 2003, 12(1):17-22
57. Alamo L, Fischer U. Contrast-enhanced color Doppler ultrasound characteristics in hypervascular breast tumors: comparison with MRI. Eur Radio, 2001, 11(6):970-977
58. Warren R, Kessar P. A method of coil localization for breast lesions seen only on MRI. Br J Radiol., 2001, 74(882):548-551
59. Schulz-Wendtland R, Kramer S, Lang N, et al. Ultrasonic guided microbiopsy in mammary diagnosis: indications, technique and results. Anticancer Res, 1998, 18(3C):2145-2146
60. Izumori A, Takebe K, Sato A. Ultrasound findings and histological features of ductal carcinoma in situ detected by ultrasound examination alone. Breast Cancer, 2010, 17(2):136-141
61. Ozdemir A, Ozdemir H, Maral I, et al. Differential diagnosis of solid breast lesions: contribution of Doppler studies to mammography and gray scale imaging. J Ultrasound Med, 2001, 20(10):1091-1101
62. Lee SW, Choi HY, Baek SY, et al. Role of color and power doppler imaging in differentiating between malignant and benign solid breast masses. J Clin Ultrasound, 2002, 30(8):459-464
63. Mesaki K, Hisa N, Kubota K, et al. Differentiation of benign and malignant breast tumors using Doppler spectral parameters including acceleration time index. Oncol Rep, 2003, 10(4):945-950
64. Madjar H, Prompeler HJ, Del Favero C, et al. A new Doppler signal enhancing agent for flow assessment in breast lesions. Eur J Ultrasound, 2000,12(2):123-130
65. Hall TJ, Oberait AA, Barbone PE, et al. Elastic nonlinearity imaging. Conf Proc IEEE Eng Med Biol Soc, 2009, 1967-1970
66. Regini E, Bagnera S, Tota D, et al. Role of sonoelastography in characterising breast nodules. Preliminary experience with 120 lesions. Radiol Med, 2010, 115(4):551-562
67. Chiorean AR, Duma MM, Dudea SM, et al. Sonoelastographically guided preoperative localization of suspicious breast microcalcifications detected with mammography. Ultraschall Med, 2009, 30(5):492-493
68.陈立斌,许幼峰,曹涌,等.超声综合评分法诊断乳腺癌的价值.中国超声诊断杂志, 2005, 6(11):4
69. Adams RF, Parulekar V, Hughes C, et al. Radiologic characteristics and management of screen-detected metastatic carcinoid tumor of the breast: a case report. Clin Breast Cancer, 2009, 9(3):189-192
70. Schrading S, Simon B, Braun M, et al. MRI-guided breast biopsy: influence of choice of vacuum biopsy system on the mode of biopsy of MRI-only suspicious breast lesions. AJR Am J Roentgenol, 2010, 194(6):1650-1657
71. Orel SG, Schnall MD, LiVolsi VA, et al. Suspicious breast lesions: MR imaging with radiologic-pathologic correlation. Radiology, 1994, 190(2):485-493
72. Stomper PC, Winston JS, Herman S, et al. Angiogenesis and dynamic MR imaging gadolinium enhancement of malignant and benign breast lesions. Breast Cancer Res Treat., 1997, 45(1):39-46
73. Siegmann KC, Muller-Schimpfle M, Schick F, et al. MR imaging-detected breast lesions: histopathologic correlation of lesion characteristics and signal intensity data. AJR Am J Roentgenol, 2002, 178(6):1403-1409
74. Sakamoto N, Tozaki M, Higa K, et al. Categorization of non-mass-like breast lesions detected by MRI. Breast Cancer, 2008, 15(3):241-246
75. Liberman L, Morris EA, Lee MJ, et al. Breast lesions detected on MR imaging: features and positive predictive value. AJR Am J Roentgenol, 2002, 179(1):171-178
76. Perretta T, Pistolese CA, Bolacchi F, et al. MR imaging-guided 10-gauge vacuum-assisted breast biopsy: histological characterisation. Radiol Med, 2008, 113(6):830-840
77. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin, 2006, 56(2):106-130
78.刘荫华,徐玲,叶京明,等.加快建立符合我国卫生经济学的乳腺癌早诊体系.中国实用外科杂志, 2009, 29(3):4
79. Kerlikowske K, Grady D, Barclay J, et al. Effect of age, breast density, and family history on the sensitivity of first screening mammography. JAMA, 1996, 276(1):33-38
80.王瑞霞王晓慧,薛小宁.彩色多普勒超声鉴别乳腺良恶性肿瘤的临床.现代肿瘤医学, 2008,16 (7):2
81.张燕宏.彩色多普勒超声对乳腺良恶性肿瘤的鉴别诊断.现代中西医结合杂志, 2008, 17(7):4
82.王棍,蒋吉鹏,焦彤.三维超声成像对乳腺肿块的诊断价值.天津医药, 2009, 37(7):2
83.胡永升.现代乳腺影像诊断学.北京:科学出版社, 2001, 3
84. Rieber A, Schramm K, Helms G, et al. Breast-conserving surgery and autogenous tissue reconstruction in patients with breast cancer: efficacy of MRI of the breast in the detection of recurrent disease. Eur Radiol, 2003, 13(4):780-787
85. Kneeshaw PJ, Turnbull LW, Drew PJ. Current applications and future direction of MR mammography. Br J Cancer, 2003, 88(1):4-10
86. Lucht RE, Delorme S, Hei J, et al. Classification of signal-time curves obtained by dynamic magnetic resonance mammography: statistical comparison of quantitative methods. Invest Radiol, 2005, 40(7):442-447
87. Morris EA, Liberman L, Ballon DJ, et al. MRI of occult breast carcinoma in a high-risk population. AJR Am J Roentgenol, 2003, 181(3):619-626
88.陶敏燕.钼靶X线对诊断乳腺癌的价值.中国实用医药, 2008, 3(6):1
89. Amant F, Deckers S, Van Calsteren K, et al. Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur J Cancer, 2010, 46(18):3158-3168
90. Kopans DB. Re: Interval breast cancers in the screening mammography program of British Columbia: analysis and classification. AJR Am J Roentgenol, 1995, 164(5):1298-1299
91. Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factorsthat influence them: an analysis of 27,825 patient evaluations. Radiology, 2002, ;225(1):165-175
92. Mandelson MT, Oestreicher N, Porter PL, et al. Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst, 2000, 92(13):1081-1087
93.王荣福.乳腺癌影像诊断技术应用进展.中国医学影像技术, 2009, 25(5):3
94.王琨蒋吉鹏,焦彤.三维超声成像对乳腺肿块的诊断价值.天津医药, 2009, 37(7):2
95. Desai RR, Krouskop TA, Righetti R. Elastography using harmonic ultrasonic imaging: a feasibility study. Ultrason Imaging, 2010, 32(2):103-117
96. Kumm TR, Szabunio MM. Elastography for the characterization of breast lesions: initial clinical experience. Cancer Control, 2010, 17(3):156-161
97. Giuseppetti GM, Martegani A, Di Cioccio B, et al. Elastosonography in the diagnosis of the nodular breast lesions: preliminary report. Radiol Med, 2005, 110(1-2):69-76
98. Karasawa K, Mitsumori M, Yamauchi C, et al. Treatment outcome of breast-conserving therapy in patients with positive or close resection margins: Japanese multi institute survey for radiation dose effect. Breast Cancer, 2005,12(2):91-98
99. Baltzer PA, Vag T, Dietzel M, et al. Computer-aided interpretation of dynamic magnetic resonance imaging reflects histopathology of invasive breast cancer. Eur Radiol,2010,20(7):1563-1571
100. Liberman L, Morris EA, Dershaw DD, et al. MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. AJR Am J Roentgenol, 2003,180(4):901-910
101. Ophir J, Cespedes I, Ponnekanti H, et al. Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging, 1991,13(2):111-134
102. Agaba EA. Re: Pathologic cervical burst fracture presenting with airway compromise. South Med J, 2010, 103(6):497
103. Horiguchi J, Iino Y, Koibuchi Y, et al. Breast-conserving therapy versus modified radical mastectomy in the treatment of early breast cancer in Japan. Breast Cancer, 2002,9(2):160-165
104. Kristoffersen Wiberg M, Aspelin P, Sylvan M, et al. Comparison of lesion sizeestimated by dynamic MR imaging, mammography and histopathology in breast neoplasms. Eur Radiol, 2003, 13(6):1207-1212
105. Wasser K, Sinn HP, Fink C, et al. Accuracy of tumor size measurement in breast cancer using MRI is influenced by histological regression induced by neoadjuvant chemotherapy. Eur Radiol, 2003, 13(6):1213-1223
106. Wasser K, Klein SK, Fink C, et al. Evaluation of neoadjuvant chemotherapeutic response of breast cancer using dynamic MRI with high temporal resolution. Eur Radiol, 2003, 13(1):80-87
107. Yamagami T, Yuen S, Sawai K, et al. MR imaging-guided axillary node biopsy for breast cancer: initial findings. Eur Radiol ,2004, 14(1):151-156
108.刘琳,徐艳燕.影像学检查在乳腺导管原位癌诊断中的联合应用.医械临床, 2010, 31(4):2
109.司淑芳,贾红岩.多种影像学联合检查诊断早期乳腺癌的临床价值.山东医药, 2010, 21(50):2
110.廖嘉煦李林. CR钼靶联合彩色多普勒超声检查对乳腺癌的诊断价值.实用医院医药杂志, 2010, 3(7):3
111. Heikkila J, Karjalainen T, Vauhkonen M, et al. Simulations of localized harmonic motions on a blood vessel wall induced by an acoustic radiation force used in ultrasound elastography. Phys Med Biol, 2006, 51(18):4587-4601
112. Choi YJ, Ko EY, Han BK, et al. High-resolution ultrasonographic features of axillary lymph node metastasis in patients with breast cancer. Breast, 2009, 18(2):119-122
113. Athanasiou A, Tardivon A, Tanter M, et al. Breast lesions: quantitative elastography with supersonic shear imaging--preliminary results. Radiology, 2010, 256(1):297-303
114. Schaefer FK, Heer I, Schaefer PJ, et al. Breast ultrasound elastography-Results of 193 breast lesions in a prospective study with histopathologic correlation. Eur J Radiol, 2011, 77(3):450-456
115.王僖,李安华,王悦,等.超声弹性成像对乳腺实质肿瘤的初步研究.中国超声医学杂志, 2006, 22(3):3
116.曾婕,罗葆明,欧冰等.乳腺超声弹性成像8分评分标准价值的探讨.中国超声医学杂志, 2007, 23(6):3
117. Shiina T, Yamakawa M, Nitta N, et al. Recent progress of ultrasound elasticityimaging technology. Seven Congress of the Asian Federation for Societies for Ultrasound in Medicine and Biology(Abstract). Utsunomiya,Tochigi,Japan, 2004, 198
118.李萍,陈苏宁,宋烨,等.实时超声弹性成像在鉴别乳腺肿块中的诊断价值.同济大学学报(医学版), 2010, 31(2):94-97
119. Sardanelli F, Boetes C, Borisch B, et al. Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer, 2010, 46(8):1296-1316
120.庄承成,肖萤.超声弹性成像与钼靶X线成像对乳腺病灶临床诊断价值的比较.中南大学学报(医学版), 2009,34(1):5
121. Obenauer S, Hermann KP, Grabbe E. Applications and literature review of the BI-RADS classification. Eur Radiol, 2005, 15(5):1027-1036
122. Kadour Leong LC, Sim LS, Lee YS, et al. A prospective study to compare the diagnostic performance of breast elastography versus conventional breast ultrasound. Clin Radiol, 2010, 65(11):887-894
123. MJ, Adams R, English R, et al. Slip imaging: reducing ambiguity in breast lesion assessment. Ultrasound Med Biol, 2010, 36(12):2027-2035
124. Horiguchi J, Koibuchi Y, Takei H, et al. Breast-conserving surgery following radiation therapy of 50 Gy in stages I and II carcinoma of the breast: the experience at one institute in Japan. Oncol Rep, 2002, 9(5):1053-1057
125. Feng S, Lotz T, Chase JG, et al. An image based vibration sensor for soft tissue modal analysis in a Digital Image Elasto Tomography (DIET) system. Conf Proc IEEE Eng Med Biol Soc, 2010, 25-28
126. Ginat DT, Destounis SV, Barr RG, et al. US elastography of breast and prostate lesions. Radiographics, 2009, 29(7):2007-2016
127. Chung SY, Moon WK, Choi JW, et al. Differentiation of benign from malignant nonpalpable breast masses: a comparison of computer-assisted quantification and visual assessment of lesion stiffness with the use of sonographic elastography. Acta Radiol, 2010, 51(1):9-14
2.许红毛德强,王燕.重庆市女性肿瘤发病率及年龄特征分析.重庆医学,2010,39(11):2
3. Kok DL, Chang JH, Erbas B, et al. Urban-rural differences in the management of screen-detected invasive breast cancer and ductal carcinoma in situ in victoria. ANZ J Surg,2006,76(11):996-1001
4. Zorzi M, Puliti D, Vettorazzi M, et al. Mastectomy rates are decreasing in the era of service screening: a population-based study in Italy (1997-2001). Br J Cancer, 2006, 95(9):1265-1268
5.成克伦. 200例乳腺癌临床病理分析.中国妇幼保健, 2009, 24(26):2
6. Malik AM, Pathan R, Shaikh NA, et al. Pattern of presentation and management of ca breast in developing countries. There is a lot to do. J Pak Med Assoc, 2010, 60(9):718-721
7. Evans A, Whelehan P, Thomson K, et al. Quantitative shear wave ultrasound elastography: initial experience in solid breast masses. Breast Cancer Res, 2010,12(6):R104
8. Sariego J. Breast cancer in the young patient. Am Surg, 2010,76(12):1397-1400
9. Baker JA, Kornguth PJ, Soo MS, et al. Sonography of solid breast lesions: observer variability of lesion description and assessment. AJR Am J Roentgenol,1999,172(6):1621-1625
10. Kuba S, Ohtani H, Yamaguchi J, et al. Incomplete inside-out growth pattern in invasive breast carcinoma: association with lymph vessel invasion and recurrence-free survival. Virchows Arch., 2011,458(2):159-169
11.李朝明,郭永萍,李登维.乳腺钼靶X线摄影与数字化摄影.医用放射技术杂志,2005,14(7):2
12.岳建国.乳腺癌钼靶X线征象分析.实用放射学杂志,2008,24(9):2
13. Luini A, Gatti G, Brenelli F, et al. Male breast cancer in a young patient treated with nipple-sparing mastectomy: case report and review of the literature. Tumori,2007,93(1):118-120
14. Bharat A, Aft RL, Gao F, et al. Patient and tumor characteristics associated with increased mortality in young women (< or =40 years) with breast cancer. J Surg Oncol, 2009,100(3):248-251
15.史英琴满守东,杨光.50例乳腺实性肿块超声诊断分析.当代医学, 2010,114(19):2
16.张宇靖.超声诊断乳腺癌的价值.中国当代医学,2007,6(13):1
17. Katsinelos P, Stavros D, Pirpilidis I, et al. Unobstructed biliary tract dilatation in a patient with breast carcinoma and dermatomyositis: a new paraneoplastic manifestation? Am J Gastroenterol,1999,94(11):3383-3385
18. Son EJ, Kim EK, Kim JA, et al. Diagnostic value of 3D fast low-angle shot dynamic MRI of breast papillomas. Yonsei Med J, 2009,50(6):838-844
19. Cecil KM, Schnall MD, Siegelman ES, et al. The evaluation of human breast lesions with magnetic resonance imaging and proton magnetic resonance spectroscopy. Breast Cancer Res Treat, 2001, 68(1):45-54
20. Krishnamurthy S, Sneige N, Bedi DG, et al. Role of ultrasound-guided fine-needle aspiration of indeterminate and suspicious axillary lymph nodes in the initial staging of breast carcinoma. Cancer, 2002, 95(5):982-988
21. Kumar AS, Bhatia V, Henderson IC. Overdiagnosis and overtreatment of breast cancer: rates of ductal carcinoma in situ: a US perspective. Breast Cancer Res, 2005,7(6):271-275
22. Moon WK, Myung JS, Lee YJ, et al. US of ductal carcinoma in situ. Radiographics., 2002, 22(2):269-280
23. Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology, 2006, 239(2):341-350
24. Fowlkes JB, Emelianov SY, Pipe JG, et al. Magnetic-resonance imaging techniques for detection of elasticity variation. Med Phys, 1995, 22(11 Pt 1):1771-1778
25. Zhi H, Ou B, Luo BM, et al. Comparison of ultrasound elastography, mammography, and sonography in the diagnosis of solid breast lesions. J Ultrasound Med, 2007, 26(6):807-815
26.罗葆明,欧冰,冯霞,等.乳腺疾病实时组织弹性成像与病理对照的初步探讨.中国超声医学杂志, 2005, 21(9):3
27. Krouskop TA, Wheeler TM, Kallel F, et al. Elastic moduli of breast and prostate tissues under compression. Ultrason Imaging, 1998, 20(4):260-274
28. Hiltawsky KM, Kruger M, Starke C, et al. Freehand ultrasound elastography of breast lesions: clinical results. Ultrasound Med Biol, 2001, 27(11):1461-1469
29. Jiang J, Hall TJ. A generalized speckle tracking algorithm for ultrasonic strain imaging using dynamic programming. Ultrasound Med Biol, 2009, 35(11):1863-1879
30.王怡,王涌.组织弹性成像鉴别乳腺良恶性肿块的价值评估.中国医学影像技术, 2005,21(11):3
31. Thomas A, Fischer T, Frey H, et al. Real-time elastography--an advanced method of ultrasound: First results in 108 patients with breast lesions. Ultrasound Obstet Gynecol., 2006, 28(3):335-340
32. Orel S. Who should have breast magnetic resonance imaging evaluation? J Clin Oncol, 2008, 26(5):703-711
33.周景玮,陈克敏,刘林祥,等.乳腺疾病的MRI与钼钯诊断.现代医用影像学, 2006, 15(6):4
34. Kuhl CK, Bieling HB, Gieseke J, et al. Healthy premenopausal breast parenchyma in dynamic contrast-enhanced MR imaging of the breast: normal contrast medium enhancement and cyclical-phase dependency. Radiology, 1997, 203(1):137-144
35. Coulthard A, Potterton AJ. Pitfalls of breast MRI. Br J Radiol, 2000, 73(870):665-671
36. Houssami N, Morrow M. Pre-operative breast MRI in women with recently diagnosed breast cancer--where to next? Breast, 2010, 19(1):1-2
37. Pinto Pereira SM, Hipwell JH, McCormack VA, et al. Automated registration of diagnostic to prediagnostic x-ray mammograms: evaluation and comparison to radiologists' accuracy. Med Phys, 2010, 37(9):4530-4539
38. Lorenzen J, Wedel AK, Lisboa BW, Loning T, et al. [Diagnostic mammography and sonography: concordance of the breast imaging reporting assessments and final clinical outcome]. Rofo, 2005, 177(11):1545-1551
39. Wind JJ, Ammerman JM. Pathologic cervical burst fracture presenting with airway compromise. South Med J, 2010, 103(6):551-553
40. Warner E, Causer PA. MRI surveillance for hereditary breast-cancer risk. Lancet,2005, 365(9473):1747-1749
41. Weatherall PT, Evans GF, Metzger GJ, et al. MRI vs. histologic measurement of breast cancer following chemotherapy: comparison with x-ray mammography and palpation. J Magn Reson Imaging, 2001 ,13(6):868-875
42.刘黎明静国庆,李立军.数字化钼靶X线摄影对早期乳腺癌的诊断价值.西南军医, 2010, 12(4):2
43.吴树强赵朝华,李普查.超声、X线钼靶检查及两者联合应用对乳腺癌的诊断价值.现代肿瘤医学, 2010, 18(7):3
44. Wu F, Wang ZB, Chen WZ, et al. Extracorporeal focused ultrasound surgery for treatment of human solid carcinomas: early Chinese clinical experience. Ultrasound Med Biol, 2004, 30(2):245-260
45. Singh S, Pradhan S, Shukla RC, et al. Color Doppler ultrasound as an objective assessment tool for chemotherapeutic response in advanced breast cancer. Breast Cancer, 2005, 12(1):45-51
46. Orsi F, Zhang L, Arnone P, et al. High-intensity focused ultrasound ablation: effective and safe therapy for solid tumors in difficult locations. AJR Am J Roentgenol, 2010, 195(3):W245-252
47. Kang DK, Kim MJ, Jung YS, et al. Clinical application of multidetector row computed tomography in patient with breast cancer. J Comput Assist Tomogr. , 2008, 32(4):583-598
48. Uematsu T, Yuen S, Kasami M, et al. Comparison of magnetic resonance imaging, multidetector row computed tomography, ultrasonography, and mammography for tumor extension of breast cancer. Breast Cancer Res Treat, 2008, 112(3):461-474
49. Hikino H, Yasui K, Ozaki N, et al. Significance of preoperative lymphoscintigraphy and thin-slice computed tomography on sentinel node assessment: metastatic sentinel node in a lateral paramammary lesion out of axillary nodes from breast cancer. Radiat Med, 2006, 24(8):583-586
50. Fujita T, Doihara H, Takabatake D, et al. Multidetector row computed tomography for diagnosing intraductal extension of breast carcinoma. J Surg Oncol, 2005, 91(1):10-16
51. Erickson SJ, Godavarty A. Hand-held based near-infrared optical imaging devices: a review. Med Eng Phys, 2009, 31(5):495-509
52. Gershon D. Lobbyists prompt US breast cancer campaign. Nature, 1993, 366(6456):601
53. Hoffman RL. Thermography in the detection of breast malignancy. Am J Obstet Gynecol, 1967, 98(5):681-686
54.郑秀萍.红外热图对乳腺疾病的诊断与分析.实用医技杂志, 2009, 16(12):1
55. Kashima Y, Shimojima Y, Fukushima K, et al. Paraneoplastic neurologic syndrome associated with small breast cancer: diagnostic value of FDG-PET for detection of underlying malignancy. Intern Med, 2005, 44(5):522-523
56. Heinisch M, Gallowitsch HJ, Mikosch P, et al. Comparison of FDG-PET and dynamic contrast-enhanced MRI in the evaluation of suggestive breast lesions. Breast, 2003, 12(1):17-22
57. Alamo L, Fischer U. Contrast-enhanced color Doppler ultrasound characteristics in hypervascular breast tumors: comparison with MRI. Eur Radio, 2001, 11(6):970-977
58. Warren R, Kessar P. A method of coil localization for breast lesions seen only on MRI. Br J Radiol., 2001, 74(882):548-551
59. Schulz-Wendtland R, Kramer S, Lang N, et al. Ultrasonic guided microbiopsy in mammary diagnosis: indications, technique and results. Anticancer Res, 1998, 18(3C):2145-2146
60. Izumori A, Takebe K, Sato A. Ultrasound findings and histological features of ductal carcinoma in situ detected by ultrasound examination alone. Breast Cancer, 2010, 17(2):136-141
61. Ozdemir A, Ozdemir H, Maral I, et al. Differential diagnosis of solid breast lesions: contribution of Doppler studies to mammography and gray scale imaging. J Ultrasound Med, 2001, 20(10):1091-1101
62. Lee SW, Choi HY, Baek SY, et al. Role of color and power doppler imaging in differentiating between malignant and benign solid breast masses. J Clin Ultrasound, 2002, 30(8):459-464
63. Mesaki K, Hisa N, Kubota K, et al. Differentiation of benign and malignant breast tumors using Doppler spectral parameters including acceleration time index. Oncol Rep, 2003, 10(4):945-950
64. Madjar H, Prompeler HJ, Del Favero C, et al. A new Doppler signal enhancing agent for flow assessment in breast lesions. Eur J Ultrasound, 2000,12(2):123-130
65. Hall TJ, Oberait AA, Barbone PE, et al. Elastic nonlinearity imaging. Conf Proc IEEE Eng Med Biol Soc, 2009, 1967-1970
66. Regini E, Bagnera S, Tota D, et al. Role of sonoelastography in characterising breast nodules. Preliminary experience with 120 lesions. Radiol Med, 2010, 115(4):551-562
67. Chiorean AR, Duma MM, Dudea SM, et al. Sonoelastographically guided preoperative localization of suspicious breast microcalcifications detected with mammography. Ultraschall Med, 2009, 30(5):492-493
68.陈立斌,许幼峰,曹涌,等.超声综合评分法诊断乳腺癌的价值.中国超声诊断杂志, 2005, 6(11):4
69. Adams RF, Parulekar V, Hughes C, et al. Radiologic characteristics and management of screen-detected metastatic carcinoid tumor of the breast: a case report. Clin Breast Cancer, 2009, 9(3):189-192
70. Schrading S, Simon B, Braun M, et al. MRI-guided breast biopsy: influence of choice of vacuum biopsy system on the mode of biopsy of MRI-only suspicious breast lesions. AJR Am J Roentgenol, 2010, 194(6):1650-1657
71. Orel SG, Schnall MD, LiVolsi VA, et al. Suspicious breast lesions: MR imaging with radiologic-pathologic correlation. Radiology, 1994, 190(2):485-493
72. Stomper PC, Winston JS, Herman S, et al. Angiogenesis and dynamic MR imaging gadolinium enhancement of malignant and benign breast lesions. Breast Cancer Res Treat., 1997, 45(1):39-46
73. Siegmann KC, Muller-Schimpfle M, Schick F, et al. MR imaging-detected breast lesions: histopathologic correlation of lesion characteristics and signal intensity data. AJR Am J Roentgenol, 2002, 178(6):1403-1409
74. Sakamoto N, Tozaki M, Higa K, et al. Categorization of non-mass-like breast lesions detected by MRI. Breast Cancer, 2008, 15(3):241-246
75. Liberman L, Morris EA, Lee MJ, et al. Breast lesions detected on MR imaging: features and positive predictive value. AJR Am J Roentgenol, 2002, 179(1):171-178
76. Perretta T, Pistolese CA, Bolacchi F, et al. MR imaging-guided 10-gauge vacuum-assisted breast biopsy: histological characterisation. Radiol Med, 2008, 113(6):830-840
77. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin, 2006, 56(2):106-130
78.刘荫华,徐玲,叶京明,等.加快建立符合我国卫生经济学的乳腺癌早诊体系.中国实用外科杂志, 2009, 29(3):4
79. Kerlikowske K, Grady D, Barclay J, et al. Effect of age, breast density, and family history on the sensitivity of first screening mammography. JAMA, 1996, 276(1):33-38
80.王瑞霞王晓慧,薛小宁.彩色多普勒超声鉴别乳腺良恶性肿瘤的临床.现代肿瘤医学, 2008,16 (7):2
81.张燕宏.彩色多普勒超声对乳腺良恶性肿瘤的鉴别诊断.现代中西医结合杂志, 2008, 17(7):4
82.王棍,蒋吉鹏,焦彤.三维超声成像对乳腺肿块的诊断价值.天津医药, 2009, 37(7):2
83.胡永升.现代乳腺影像诊断学.北京:科学出版社, 2001, 3
84. Rieber A, Schramm K, Helms G, et al. Breast-conserving surgery and autogenous tissue reconstruction in patients with breast cancer: efficacy of MRI of the breast in the detection of recurrent disease. Eur Radiol, 2003, 13(4):780-787
85. Kneeshaw PJ, Turnbull LW, Drew PJ. Current applications and future direction of MR mammography. Br J Cancer, 2003, 88(1):4-10
86. Lucht RE, Delorme S, Hei J, et al. Classification of signal-time curves obtained by dynamic magnetic resonance mammography: statistical comparison of quantitative methods. Invest Radiol, 2005, 40(7):442-447
87. Morris EA, Liberman L, Ballon DJ, et al. MRI of occult breast carcinoma in a high-risk population. AJR Am J Roentgenol, 2003, 181(3):619-626
88.陶敏燕.钼靶X线对诊断乳腺癌的价值.中国实用医药, 2008, 3(6):1
89. Amant F, Deckers S, Van Calsteren K, et al. Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur J Cancer, 2010, 46(18):3158-3168
90. Kopans DB. Re: Interval breast cancers in the screening mammography program of British Columbia: analysis and classification. AJR Am J Roentgenol, 1995, 164(5):1298-1299
91. Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factorsthat influence them: an analysis of 27,825 patient evaluations. Radiology, 2002, ;225(1):165-175
92. Mandelson MT, Oestreicher N, Porter PL, et al. Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst, 2000, 92(13):1081-1087
93.王荣福.乳腺癌影像诊断技术应用进展.中国医学影像技术, 2009, 25(5):3
94.王琨蒋吉鹏,焦彤.三维超声成像对乳腺肿块的诊断价值.天津医药, 2009, 37(7):2
95. Desai RR, Krouskop TA, Righetti R. Elastography using harmonic ultrasonic imaging: a feasibility study. Ultrason Imaging, 2010, 32(2):103-117
96. Kumm TR, Szabunio MM. Elastography for the characterization of breast lesions: initial clinical experience. Cancer Control, 2010, 17(3):156-161
97. Giuseppetti GM, Martegani A, Di Cioccio B, et al. Elastosonography in the diagnosis of the nodular breast lesions: preliminary report. Radiol Med, 2005, 110(1-2):69-76
98. Karasawa K, Mitsumori M, Yamauchi C, et al. Treatment outcome of breast-conserving therapy in patients with positive or close resection margins: Japanese multi institute survey for radiation dose effect. Breast Cancer, 2005,12(2):91-98
99. Baltzer PA, Vag T, Dietzel M, et al. Computer-aided interpretation of dynamic magnetic resonance imaging reflects histopathology of invasive breast cancer. Eur Radiol,2010,20(7):1563-1571
100. Liberman L, Morris EA, Dershaw DD, et al. MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. AJR Am J Roentgenol, 2003,180(4):901-910
101. Ophir J, Cespedes I, Ponnekanti H, et al. Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging, 1991,13(2):111-134
102. Agaba EA. Re: Pathologic cervical burst fracture presenting with airway compromise. South Med J, 2010, 103(6):497
103. Horiguchi J, Iino Y, Koibuchi Y, et al. Breast-conserving therapy versus modified radical mastectomy in the treatment of early breast cancer in Japan. Breast Cancer, 2002,9(2):160-165
104. Kristoffersen Wiberg M, Aspelin P, Sylvan M, et al. Comparison of lesion sizeestimated by dynamic MR imaging, mammography and histopathology in breast neoplasms. Eur Radiol, 2003, 13(6):1207-1212
105. Wasser K, Sinn HP, Fink C, et al. Accuracy of tumor size measurement in breast cancer using MRI is influenced by histological regression induced by neoadjuvant chemotherapy. Eur Radiol, 2003, 13(6):1213-1223
106. Wasser K, Klein SK, Fink C, et al. Evaluation of neoadjuvant chemotherapeutic response of breast cancer using dynamic MRI with high temporal resolution. Eur Radiol, 2003, 13(1):80-87
107. Yamagami T, Yuen S, Sawai K, et al. MR imaging-guided axillary node biopsy for breast cancer: initial findings. Eur Radiol ,2004, 14(1):151-156
108.刘琳,徐艳燕.影像学检查在乳腺导管原位癌诊断中的联合应用.医械临床, 2010, 31(4):2
109.司淑芳,贾红岩.多种影像学联合检查诊断早期乳腺癌的临床价值.山东医药, 2010, 21(50):2
110.廖嘉煦李林. CR钼靶联合彩色多普勒超声检查对乳腺癌的诊断价值.实用医院医药杂志, 2010, 3(7):3
111. Heikkila J, Karjalainen T, Vauhkonen M, et al. Simulations of localized harmonic motions on a blood vessel wall induced by an acoustic radiation force used in ultrasound elastography. Phys Med Biol, 2006, 51(18):4587-4601
112. Choi YJ, Ko EY, Han BK, et al. High-resolution ultrasonographic features of axillary lymph node metastasis in patients with breast cancer. Breast, 2009, 18(2):119-122
113. Athanasiou A, Tardivon A, Tanter M, et al. Breast lesions: quantitative elastography with supersonic shear imaging--preliminary results. Radiology, 2010, 256(1):297-303
114. Schaefer FK, Heer I, Schaefer PJ, et al. Breast ultrasound elastography-Results of 193 breast lesions in a prospective study with histopathologic correlation. Eur J Radiol, 2011, 77(3):450-456
115.王僖,李安华,王悦,等.超声弹性成像对乳腺实质肿瘤的初步研究.中国超声医学杂志, 2006, 22(3):3
116.曾婕,罗葆明,欧冰等.乳腺超声弹性成像8分评分标准价值的探讨.中国超声医学杂志, 2007, 23(6):3
117. Shiina T, Yamakawa M, Nitta N, et al. Recent progress of ultrasound elasticityimaging technology. Seven Congress of the Asian Federation for Societies for Ultrasound in Medicine and Biology(Abstract). Utsunomiya,Tochigi,Japan, 2004, 198
118.李萍,陈苏宁,宋烨,等.实时超声弹性成像在鉴别乳腺肿块中的诊断价值.同济大学学报(医学版), 2010, 31(2):94-97
119. Sardanelli F, Boetes C, Borisch B, et al. Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer, 2010, 46(8):1296-1316
120.庄承成,肖萤.超声弹性成像与钼靶X线成像对乳腺病灶临床诊断价值的比较.中南大学学报(医学版), 2009,34(1):5
121. Obenauer S, Hermann KP, Grabbe E. Applications and literature review of the BI-RADS classification. Eur Radiol, 2005, 15(5):1027-1036
122. Kadour Leong LC, Sim LS, Lee YS, et al. A prospective study to compare the diagnostic performance of breast elastography versus conventional breast ultrasound. Clin Radiol, 2010, 65(11):887-894
123. MJ, Adams R, English R, et al. Slip imaging: reducing ambiguity in breast lesion assessment. Ultrasound Med Biol, 2010, 36(12):2027-2035
124. Horiguchi J, Koibuchi Y, Takei H, et al. Breast-conserving surgery following radiation therapy of 50 Gy in stages I and II carcinoma of the breast: the experience at one institute in Japan. Oncol Rep, 2002, 9(5):1053-1057
125. Feng S, Lotz T, Chase JG, et al. An image based vibration sensor for soft tissue modal analysis in a Digital Image Elasto Tomography (DIET) system. Conf Proc IEEE Eng Med Biol Soc, 2010, 25-28
126. Ginat DT, Destounis SV, Barr RG, et al. US elastography of breast and prostate lesions. Radiographics, 2009, 29(7):2007-2016
127. Chung SY, Moon WK, Choi JW, et al. Differentiation of benign from malignant nonpalpable breast masses: a comparison of computer-assisted quantification and visual assessment of lesion stiffness with the use of sonographic elastography. Acta Radiol, 2010, 51(1):9-14