乳腺良、恶性病变MR-DCE、DWI特征及诊断价值分析  

Characteristics and Diagnostic Value ofMR-DCE and DWI for Benign and Malignant Breast Lesions

作　　者：郭富强[1] 陈喜中[1] Guo Fuqiang;Chen Xizhong(Zhoukou City Central Hospital,Zhoukou 466000,China)

机构地区：[1]周口市中心医院,河南周口466000

出　　处：《哈尔滨医药》2020年第1期23-25,共3页Harbin Medical Journal

摘　　要：目的分析乳腺良、恶性病变MR动态增强扫描(MR-DCE)、弥散加权成像(DWI)特征及诊断价值。方法研究对象为2015年1月至2018年6月在我院行MR-DCE、DWI检查的92例乳腺良、恶性病变患者,均经组织学病理活检确诊,比较MR-DCE、DWI参数在乳腺良、恶性病变中的差异,并以组织学诊断结果为状态变量绘制ROC曲线。结果59例确诊乳腺良性病变,35例恶性病变;良恶性病变患者最大信号强度(SImax)、最大信号强度差值(SId)、峰值时间(Tpeak)比较差异无统计学意义(P>0.05);但恶性病变最大上升斜率(MSI)、相对最大上升斜率(rMSI)、信号增强率(SER)均显著高于良性病变(P<0.05);相对信号增强率(rSER)、表观扩散系数(ADC)、相对表观扩散系数(rADC)均显著低于恶性病变(P<0.05);经ROC曲线分析,仅MSI、rMSI、SER及DWI参数ADC、rADC对乳腺良恶性病变有诊断价值,且联合诊断时AUC值最高,为0.944,敏感度及特异度为82.00%、97.00%。结论MR-DCE及DWI单一参数鉴别诊断乳腺良恶性病变具一定的临床价值,但联合诊断时效能最佳,值得临床推介。Objective To analyze the characteristics and diagnostic value of MR dynamic contrast-enhanced scan(MR-DCE)and diffusion-weighted imaging(DWI)for benign and malignant breast lesions.Methods 92 patients with benign and malignant breast lesions who underwent MR-DCE and DWI in the hospital from January 2015 to June 2018were selected as subjects.All of them were diagnosed by histopathological biopsy.The MR-DCE and DWI parameters of benign and malignant breast lesions were compared.ROC curves were plotted with histological diagnosis results asstate variables.Results 59 cases were diagnosed with benign breast lesions and 35 cases had malignant lesions.There was no significant difference in the maximum signal intensity(SImax),the maximum signal intensity difference(SId)or peak time(Tpeak)between patients with benign and malignant lesions(P>0.05).However,the maximal slope increasing(MSI),the relative MSI(rMSI)and signal enhancement rate(SER)of malignant lesions were significantly higher than those of benign lesions(P<0.05),while the relative SER(rSER),apparent diffusion coefficient(ADC)and relative ADC(rADC)were significantly lower than those of malignant lesions(P<0.05).ROC curve analysis showed that only the MSI,rMSI,SER and DWI parameters ADC and rADC were of diagnostic value for benign and malignant breast lesions.The AUC of combined diagnosis was the largest(0.944),and the sensitivity and specificity were 82.00%and 97.00%.Conclusion MR-DCE and DWI single-parameter differential diagnosis of benign and malignant breast lesions is of certain clinical value,but the efficiency of combined diagnosis is the best.

关 键 词：乳腺病变 MR-DCE DWI 诊断价值 

分 类 号：R445.2[医药卫生—影像医学与核医学]