MRI动态增强扫描联合扩散峰度成像对乳腺良恶性病变的鉴别诊断价值  

Differential diagnosis value of DCE-MRI combined with DKI for benign and malignant breast lesions

作　　者：吴杰 敬宗林[2,3] 黄小华 杨茂江[2] 谢少利 WU Jie;JING Zonglin;HUANG Xiaohua;YA NG Maojiang;XIE Shaoli(Department of Radiology of Affiliated Hospital of North Sichuan Medical College,Sichuan Key Laboratory of Medical Imaging,Nanchong 637000,China.)

机构地区：[1]四川省南充市中心医院CT/MRI室,四川南充637000 [2]川北医学院附属医院放射科,四川南充637000 [3]医学影像学四川省重点实验室,四川南充637000

出　　处：《中国中西医结合影像学杂志》2020年第4期378-382,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨MRI动态增强扫描(DCE-MRI)联合扩散峰度成像(DKI)对乳腺良恶性病变的鉴别诊断价值。方法 :收集因乳腺病变行MRI检查的患者45例共50个病灶,其中良性病灶21个(良性组),恶性病灶29个(恶性组)。按DCE-MRI、DCE-MRI联合DKI 2种方法对乳腺病变进行分类,比较各组间DKI参数平均扩散系数(MD)值、平均扩散峰度(MK)值及2种分类方法的诊断效能。结果:恶性组MK值(0.90±0.19)×10-3mm2/s高于良性组(0.54±0.13)×10-3mm2/s与对照组(0.48±0.13)×10-3mm2/s,恶性组MD值(1.41±0.32)×10-3mm2/s低于良性组(1.98±0.38)×10-3mm2/s与对照组(2.25±0.26)×10-3mm2/s。以1.61×10-3mm2/s、0.73×10-3mm2/s作为MD、MK值的临界值时,可鉴别诊断乳腺良恶性病变。DCE-MRI鉴别诊断乳腺良恶性病变的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为93.0%、71.4%、81.8%、88.2%、84.0%,DCE-MRI联合DKI为93.0%、85.7%、90.0%、90.0%、90.0%。2种方法的AUC分别为0.86、0.92。结论:DKI有助于乳腺病变的诊断,联合DCE-MRI可提高对乳腺病变的诊断效能。Objective:To explore the the value of dynamic contrast-enhanced MRI(DCE-MRI) combined with diffusion kurtorsis imaging(DKI) in differential diagnosis of benign and malignant breast lesions.Methods:Totally 45 patients underrent DCE-MRI and DKI were involved.Fifty lesions were confirmed by pathology of which 21 lesions were benign(benign group) and 29 were malignant(malignant group).15 healthy brests were chosen as the control group.The DKI parameters(MD,MK value) of the three groups were compared.The classification of lesions based on DCE-MRI,DCE-MRI combined with DKI were made,and the diagnostic efficacy of the two methods were evaluated.Results:The MK value of the malignant group was significantly higher than that of the benign group and the control group,meanwhile the MD value of the malignant group was significantly lower than that of the other two groups.Using 1.61×10-3mm2/s as critical MD value and 0.73×10-3mm2/s as critical MK value between benign and malignant lesions,it helped to the differential diagnosis of breast lesions.The sensitivity,sepcificity,positive predictive value,negative predictive value,accuacy of DCE-MRI were 93.0%,71.4%,81.8%,88.2%,84.0%,and those of DCE-MRI combined of MKI were 93.0%,85.7%,90.0%,90.0%,90.0%,respectively.AUC of the two methods were 0.86 and 0.92,respectively.Conclusions:DKI quantitative parameters are contributed to diagnosis of breast lesions,and combined with DCE-MRI can increased the efficiency of the diagnostic of breast lesions.

关 键 词：乳腺病变 磁共振成像 诊断 鉴别 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]