乳腺成簇环状非肿块样强化病变的MRI特征分析及联合诊断模型建立  

Analysis of MRI features of clustered ring non-mass enhancement breast lesions and establishment of combined diagnostic model

作　　者：黄瑞岁 丁可 黄兴旺 袁红梅 杨梅霞 覃雯祺 HUANG Ruisui;DING Ke;HUANG Xingwang;YUAN Hongmei;YANG Meixia;QIN Wenqi(Department of Radiology,the Third Affiliated Hospital of Guangri Medical University,Nanning 530031,China)

机构地区：[1]广西医科大学第三附属医院放射科,广西南宁530031

出　　处：《实用放射学杂志》2023年第4期579-583,共5页Journal of Practical Radiology

摘　　要：目的分析良、恶性乳腺成簇环状非肿块样强化(NME)病变的MRI和临床特征,并建立多参数联合鉴别诊断模型。方法回顾性选取行MRI检查并经手术或活检病理证实的良、恶性乳腺成簇环状NME病变患者104例,比较两者间的MRI影像特征及临床特征,将有统计学差异的参数纳入logistic回归分析,建立多参数联合诊断模型,绘制受试者工作特征(ROC)曲线分析该模型的诊断效能。结果104例患者共107个成簇环状强化病灶,其中良性46个(42.99%),恶性61个(57.01%)。良、恶性组间比较,年龄、背景实质强化(BPE)、脂肪抑制(FS)T_(2)WI信号表现差异无统计学意义(P>0.05);最大径、表观扩散系数(ADC)值、早期强化率(EER)、分布特征、时间信号强度曲线(TIC)类型差异有统计学意义(P<0.05)。通过多因素logistic回归分析建立成簇环状强化病变的多参数联合鉴别诊断模型,该模型曲线下面积(AUC)为0.908,最大Yonden指数为74.4%,诊断的敏感度为89.1%,特异度为85.2%。结论综合分析乳腺成簇环状NME病变的最大径、ADC值、EER、分布特征、TIC类型等MRI影像特征,并结合多参数联合诊断模型,可以提高良、恶性病变的鉴别诊断能力。Objective To analyze MRI and clinical features of benign and malignant breast lesions with clustered ring non-mass enhancement(NME),and to establish a multi-parameter model for differential diagnosis.Methods A total of 104 patients with benign and malignant clustered ring NME breast lesions in MRI and confirmed by operation or biopsy pathology were retrospectively selected.MRI and clinical features were compared between benign and malignant lesions.The parameters with statistical difference were included in a logistic regression analysis,and to establish a multi-parameter combined diagnostic model to differential diagnosis benign and malignant clustered ring lesions.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficiency of the model.Results A total of 107 lesions were detected in 104 patients,including 46 benign lesions(42.99%)and 61 malignant lesions(57.01%).There were no significant differences in age,background parenchymal enhancement(BPE)and fat suppression(FS)T_(2)WI signal intensity between the benign and malignant group(P>0.05),and there were significant differences in maximum diameter,apparent diffusion coefficient(ADC)value,early enhancement rate(EER),distribution characteristics and time-signal intensity curve(TIC)between the benign and malignant group(P<0.05).The area under the curve(AUC)of the multi-parameter differential diagnosed model was 0.908 with the maximum Yonden index of 74.4%,diagnostic sensitivity of 89.1%,and specificity of 85.2%.Conclusion Comprehensively analyzing the MRI features of clustered ring NME breast lesions,such as maximum diameter,ADC value,EER,distribution characteristics,TIC types,and combined with multi-parameter diagnosis model,could improve the ability of differential diagnosis of benign and malignant lesions.

关 键 词：乳腺 成簇环状强化 磁共振成像 

分 类 号：R655.8[医药卫生—外科学] R445.2[医药卫生—临床医学]