动态对比增强磁共振成像及扩散加权成像在乳腺癌术前诊断中的应用  

Application of DCE-MRI and DWI in the preoperative diagnosis of breast cancer

作　　者：连鹏[1] 张秋芳[1] 王利[1] LIAN Peng;ZHANG Qiufang;WANG Li(Department of Radiology Xi'an No.4 Hospital, Xi’an 710004,China)

机构地区：[1]西安市第四医院影像科,陕西西安710004

出　　处：《实用放射学杂志》2019年第10期1599-1602,共4页Journal of Practical Radiology

摘　　要：目的探讨DCE-MRI及DWI在乳腺癌术前诊断中的应用。方法收集132例乳腺病变患者的资料,回顾性分析其MRI表现。132例患者术前均行DCE-MRI、MRI、DWI扫描,以病理结果为“金标准”,比较良恶性肿块早期强化率、TIC和ADC值,分析DCE-MRI联合DWI诊断乳腺癌的诊断价值。结果术后病理结果显示,132例乳腺病变患者共140个病灶,乳腺癌80例(88个),乳腺腺病52例(52个);DCE-MRI诊断恶性肿块93个?良性肿块47个;DWI诊断恶性肿块88个,良性肿块52个;两者联合诊断恶性肿块87个,良性肿块53个;两者联合诊断灵敏度高于DCE-MRI单一诊断,特异度、准确率、阳性预测值、阴性预测值均高于DCE-MRI、DWI单一诊断,差异有统计学意义(P<0.05);乳腺恶性肿块早期强化明显,TIC多呈ID型,良性肿块TIC多呈I型,良恶性肿块早期强化率及TIC类型比较,差异均有统计学意义(P<0.0 5);当b值为800s/mm2或1000s/mm2时,乳腺良恶性肿块平均ADC值比较,差异均有统计学意义(P<0.05)。结论DCE-MRI、DWI对乳腺癌术前诊断具有较高的灵敏度、特异度、准确率,两者联合诊断价值更高,为乳腺癌的早期诊断、早期治疗提供可靠的影像学依据。Objective To explore the application of DCE-MRI and DWI in the preoperative diagnosis of breast cancer.Methods The data of 132 patients with breast lesions were collected, and their MRI finding were analyzed retrospectively. 132 patients were given DCE-MRI,MRI and DWI before operation,and the pathological results were taken as gold standards,and the early enhancement rate,TIC and ADC value were compared between benign and malignant tumors,and the diagnostic value of DCE-MRI combined with DWI was analyzed in the diagnosis of breast cancer. Results Postoperative pathological results showed there were a total of 140 lesions among 132 patients with breast lesions,among which 80 cases (88 lesions) were breast cancer and 52 cases (52 lesions) were adenosis of the breast.93 malignant tumors and 47 benign tumors were diagnosed by DCE-MRI.88 malignant tumors and 52 benign tumors were diagnosed by DWI.87 malignant tumors and 53 benign tumors were diagnosed by the combination of the two methods.The sensitivity of combined diagnosis was higher than that of single DCE-MRI,and the specificity,accuracy,positive predictive value and negative predictive value were higher than those of single DCE-MRI or DWI (P<10.05).The early obvious enhancement and type Ⅲ of TIC were shown in malignant breast tumors, and type Ⅰ of TIC was shown in benign tumors,and there were statistically significant differences in the early enhancement rate and TIC type between benign and malignant tumors (P<C0.05). When the b value was 800s/mnr or 1000s/mm , there was a statistically significant difference in the mean AIX' value between benign and malignant breast tumors (P<0.05). Conclusion DCE-MRI and DWI both have high sensitivity,specificity and accuracy in the preoperative diagnosis of breast cancer,and the combined diagnosis of the two methods has higher diagnostic value, which provides a reliable imaging basis for early diagnosis and early treatment of breast cancer.

关 键 词：乳腺癌 动态对比增强磁共振成像 扩散加权成像 术前诊断 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]