MRI DWI及DCE对浆细胞乳腺炎和乳腺导管原位癌鉴别诊断中的应用价值  

Application value of MRI DWI and DCE in differential diagnosis of plasma cell mastitis and breast ductal carcinoma in situ

作　　者：沈云云 朱建国 SHEN Yunyun;ZHU Jianguo(Department of Radiology,Xinghai Hospital in Suzhou Industrial Park,Suzhou,Jiangsu 215021,China)

机构地区：[1]苏州工业园区星海医院放射科,江苏苏州215021

出　　处：《影像研究与医学应用》2022年第23期36-38,共3页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨磁共振成像(MRI)、弥散加权成像(diffusion weighted imaging,DWI)及动态对比增强(dynamic contrast enhanced,DCE)在浆细胞乳腺炎和乳腺导管原位癌鉴别诊断中的应用价值。方法:回顾性分析2016年7月-2022年3月苏州工业园区星海医院收治的119例乳腺疾病患者的病历资料与影像学资料,其中66例患者高度怀疑浆细胞乳腺炎,53例高度怀疑为乳腺导管原位癌,所有患者均接受磁共振动态增强(DCE-MRI)以及弥散加权成像(DWI)检查,研究DCE-MRI联合DWI在浆细胞乳腺炎与乳腺导管原位癌鉴别诊断中的应用价值。结果:66例高度怀疑浆细胞乳腺炎患者经组织病理实验确诊57例,DCE-MRI联合DWI诊断浆细胞乳腺炎的灵敏度为94.74%,特异度为77.78%,准确率为92.42%,一致性分析结果显示Kappa值为0.471。53例高度怀疑乳腺导管原位癌患者确诊43例,DCE-MRI联合DWI对乳腺导管原位癌灵敏度为93.02%,特异度为80.00%,准确率为90.57%,一致性分析结果显示Kappa值为0.703。浆细胞乳腺炎患者病灶平均ADC值、rADC1、rADC2值均显著高于乳腺导管原位癌患者(P<0.01);在DCE-MRI检查中浆细胞乳腺炎强化方式、TIC曲线类型以及导管形态与乳腺导管原位癌患者比较,差异有统计学意义(P<0.05)。结论:DCE-MRI联合DWI可有效提升MRI检查对浆细胞乳腺炎与乳腺导管原位癌的鉴别诊断能力,且敏感性、特异性均较高,具有应用推广价值。Objective To investigate the value of MRI,diffusion weighted imaging(DWI)and dynamic contrast enhanced(DCE in the differential diagnosis of plasma cell mastitis and ductal carcinoma in situ.Methods The medical records and imaging data of 119 breast disease patients admitted to Xinghai Hospital in Suzhou Industrial Park from July 2016 to March 2022 were analyzed retrospectively.Among them,66 patients were highly suspected of plasma cell mastitis and 53 patients were highly suspected of breast ductal carcinoma in situ.All patients received DCE-MRI and DWI,To study the value of DCE-MRI combined with DWI in differential diagnosis between plasma cell mastitis and ductal carcinoma in situ.Results Among 66 patients with high suspicion of plasma cell mastitis,57 patients were confirmed by histopathology,the sensitivity,specificity and accuracy of DCE-MRI combined with DWI to plasma cell mastitis were 94.74%,77.78%and 92.42%respectively,the consistency analysis showed that Kappa value was 0.471.Among 53 patients with high suspicion of breast ductal carcinoma in situ,43 patients were confirmed,the sensitivity,specificity and accuracy of DCE-MRI combined with DWI to breast ductal carcinoma in situ were 93.02%,80.00%and 90.57%respectively,the consistency analysis results show that Kappa value is 0.703.The average ADC value,rADC1,rADC2 value of lesions in plasma cell mastitis patients were significantly higher than those in breast ductal carcinoma in situ patients(P<0.01);In DCE-MRI,the enhancement mode of plasma cell mastitis,the type of TIC curve and the duct shape were significantly different from those of breast ductal carcinoma in situ(P<0.05).Conclusion DCE-MRI combined with DWI can effectively improve the differential diagnostic ability of MRI in plasma cell mastitis and breast ductal carcinoma in situ,and has high sensitivity and specificity,which is worthy of application and popularization.

关 键 词：浆细胞乳腺炎 乳腺导管原位癌 DCE-MRI DWI 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]