MRI动态增强TIC联合DWI在乳腺良恶性病变中的评估价值  

The evaluation value of MRI dynamic enhancement TIC combined with DWI in benign and malignant breast lesions

作　　者：王跃 胡满意 朱梓宾 Wang Yue;Hu Manyi;Zhu Zibin(Department of Imaging,Beijing Huairou Hospital/The Capital University of Medical Science Huairou Teaching Hospital,Beijing 101400,China)

机构地区：[1]北京怀柔医院/首都医科大学怀柔教学医院影像科,北京101400

出　　处：《中国医师杂志》2023年第6期895-899,共5页Journal of Chinese Physician

摘　　要：目的探讨MRI动态增强(DCE)时间-信号强度曲线(TIC)联合弥散加权成像(DWI)诊断乳腺良恶性病变的临床应用价值。方法本研究为回顾性研究,以2018年10月至2021年10月在北京怀柔医院接受诊治的95例疑似乳腺癌患者作为研究对象,均接受DCE-TIC、DCE-DWI检查,影像检查后接受穿刺活检。统计患者一般临床资料及表观弥散系数值(ADC值),以病理检测结果为"金标准",评估DCE-TIC、DCE-DWI单独及联合在乳腺良恶性病变中的诊断效能。结果95例疑似乳腺癌患者在接受穿刺活检后,病理诊断为良性病变25例,恶性病变70例,恶性病变与良性病变患者的肿块长径、ADC值相比较,差异有统计学意义(均P<0.05)。绘制受试者工作特征(ROC)曲线,DCE-DWI诊断乳腺癌的曲线下面积(AUC)为0.826。95例疑似乳腺癌患者经过DCE-TIC诊断出Ⅰ型28例,Ⅱ型27例,Ⅲ型40例,以病理诊断结果为"金标准",DCE-TIC联合DCE-DWI诊断乳腺癌的准确度、灵敏度、阴性预测值均高于单一诊断,差异有统计学意义(均P<0.05);联合诊断的特异度、阳性预测值相较单一诊断,差异无统计学意义(均P>0.05)。结论DCE-TIC、DCE-DWI均能够鉴别乳腺良恶性病变,联合诊断的准确度、灵敏度及阳性预测值均高于单一诊断,联合使用DCE-TIC、DCE-DWI有助于提高乳腺病变性质的鉴别效能。Objective To explore the clinical application value of dynamic contrast-enhanced MRI(DCE)time-signal intensity curve(TIC)combined with diffusion weighted imaging(DWI)in the diagnosis of benign and malignant breast lesions.Methods This study was a retrospective study.95 patients with suspected breast cancer who were diagnosed and treated in the Beijing Huairou Hospital from October 2018 to October 2021 were taken as the study subjects.All patients received DCE-TIC and DCE-DWI examinations,and then underwent needle biopsy after imaging examination.We evaluated the diagnostic efficacy of DCE-TIC and DCE-DWI alone and in combination in benign and malignant breast lesions by collecting general clinical data and apparent diffusion coefficient(ADC)values of patients,using pathological examination results as the"gold standard".Results A total of 95 patients with suspected breast cancer were diagnosed as benign lesions in 25 cases and malignant lesions in 70 cases after biopsy.Compared with benign lesions,the tumor diameter and ADC value of malignant lesions were significantly different(all P<0.05).The eceiver operating characteristic(ROC)curve of subjects was drawn,and the area under the curve(AUC)of DCE-DWI diagnosis of breast cancer was 0.826.95 suspected breast cancer patients were diagnosed by DCE-TIC in 28 cases of typeⅠ,27 cases of typeⅡ,and 40 cases of typeⅢ.With the pathological diagnosis results as the"gold standard",the accuracy,sensitivity,and negative predictive value of DCE-TIC combined with DCE-DWI in the diagnosis of breast cancer were higher than those of a single diagnosis,with a statistically significant difference(all P<0.05);The specificity and positive predictive value of combined diagnosis were not statistically significant compared to single diagnosis(all P>0.05).Conclusions Both DCE-TIC and DCE-DWI can differentiate benign and malignant breast lesions,and the accuracy,sensitivity,and positive predictive value of combined diagnosis are higher than those of single diagnosis.The combination of

关 键 词：乳腺肿瘤 磁共振成像 时间-信号强度曲线 磁共振成像 弥散 

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]