DCE-MRI联合DWI诊断乳腺良恶性病变的临床价值分析  

Clinical Value of DCE-MRI Combined with DWI in the Diagnosis of Benign and Malignant Breast Lesions

作　　者：史倩菲[1] 丁军明[1] 赵妍[1] SHI Qian-fei;DING Jun-ming;ZHAO Yan(Department of Medical Imaging,The Second People's Hospital of Lianyungang,Lianyungang 222000,Jiangsu Province,China)

机构地区：[1]江苏省连云港市第二人民医院医学影像科,江苏连云港222000

出　　处：《中国CT和MRI杂志》2023年第4期88-90,共3页Chinese Journal of CT and MRI

基　　金：南京医科大学康达学院科研发展基金(KD2019KYJJYB022)。

摘　　要：目的 分析磁共振动态增强(DCE-MRI)联合弥散加权成像(DWI)诊断乳腺良恶性病变的临床价值。方法 回顾性分析2019年3月至2021年9月到我院就诊的62例乳腺病变患者的临床资料。所有患者均于术前1周行3.0 T MRI平扫,DCE-MRI及DWI检查。以病理诊断结果为金标准,比较DCE-MRI检查、DWI检查及二者联合检查对乳腺良恶性病变的诊断效能。结果 本组62例患者,共71个病灶,其中乳腺恶性病变40例(46个病灶),乳腺良性病变22例(25个病灶),恶性病灶中以浸润性导管癌(43.40%)为主,良性病灶中以纤维腺瘤(36.00%)为主;乳腺良恶性病灶的边缘状态、病灶强化程度、TIC类型及ADC值比较差异有统计学意义(P<0.05),而两种病灶的形态、乳头受累、皮肤增厚、腋窝淋巴结肿大情况比较差异无统计学意义(P>0.05);DCE-MRI及DWI单独诊断乳腺良恶性病变的灵敏度(78.26%、89.13%),特异度(76.00%、64.00%)、准确率(77.46%、80.28%)均低于二者联合诊断(灵敏度91.30%、特异度92.00%、准确率91.55%)。结论 DCE-MRI联合DWI诊断乳腺癌良恶性病变可有效降低误诊、漏诊,提高诊断准确率,临床应用效果良好。Objective To analyze the clinical value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with diffusion-weighted imaging(DWI)in the diagnosis of benign and malignant breast lesions.Methods The clinical data of 62 patients with breast lesions who were treated in the hospital were retrospectively analyzed between March 2019 and September 2021.All patients underwent 3.0 T MRI plain scan,DCE-MRI and DWI at 1 week before surgery.Using pathological diagnosis results as the gold standard,the diagnostic efficiency of DCE-MRI,DWI and their combined examination on benign and malignant breast lesions was compared.Results There were 71 lesions in 62 patients in this study,including 40 cases of malignant breast lesions(46 lesions)and 22 cases of benign breast lesions(25 lesions).Malignant lesions were mainly invasive ductal carcinomas(43.40%),and benign lesions were dominated by fibroadenomas(36.00%).There were statistical differences in the marginal state,lesion enhancement,TIC type and ADC value between benign and malignant breast lesions(P<0.05),but there were no statistical differences in morphology,nipple involvement,skin thickening and axillary lymph node enlargement(P>0.05).The sensitivity,specificity and accuracy rate were(78.26%,76.00%and 77.46%) of DCE-MRI and were 89.13%,64.00% and 80.28% of DWI in diagnosing benign and malignant breast lesions,which were lower than 91.30%,92.00% and 91.55% of the combined diagnosis.Conclusion DCE-MRI combined with DWI in the diagnosis of benign and malignant breast lesions can effectively reduce misdiagnosis and missed diagnosis and improve the diagnostic accuracy rate,with good clinical application effects.

关 键 词：磁共振动态增强 弥散加权成像 乳腺良恶性病变 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]