乳腺简化MRI对致密型腺体补充筛查的应用价值  

Application value of breast MRI-abbreviated protocol for supplementary screening in dense glands

作　　者：张冬雪 张晓英 张水岚 丁莹莹[1] 李卓琳[1] ZHANG Dongxue;ZHANG Xiaoying;ZHANG Shuilan;DING Yingying;LI Zhuolin(Department of Radiology,Yunnan Cancer Hospital,Kunming 650000,China)

机构地区：[1]云南省肿瘤医院放射科,云南昆明650000

出　　处：《实用放射学杂志》2023年第7期1097-1100,1105,共5页Journal of Practical Radiology

基　　金：云南省卫生健康委员会医学后备人才培养计划项目(H-2018005)。

摘　　要：目的 分析乳腺简化磁共振成像(BMRI-AP)对致密型腺体补充筛查的价值.方法 选取行乳腺X线筛查发现异常,进一步行乳腺磁共振成像(BMRI)检查的患者112例,均为致密型腺体.乳腺X线摄影、BMRI-AP、乳腺磁共振成像常规序列(BMRI-FDP)三者诊断效能的比较采用X2检验(组间两两比较采用Bonferroni校正),并绘制受试者工作特征(ROC)曲线分析3种方法的诊断效能.BMRI-AP与BMRI-FDP的扫描时间因不符合正态分布,故采用Mann-Whitney U检验分析.结果 乳腺X线摄影、BMRI-AP、BMRI-FDP 的诊断准确性分别为 75.89%、88.39%、91.07%(X^(2)=11.607,P=0.003);BMRI-AP 与 BMRI-FDP 诊断准确性之间差异无统计学意义(X^(2)=0.436,P=0.509);而乳腺X线摄影与BMRI-AP、乳腺X线摄影与BMRI-FDP诊断准确性之间差异有统计学意义(X^(2)=5.965,P=0.015;X^(2)=9.356,P=0.002).乳腺X线摄影、BMRI-AP、BMRI-FDP 3种影像学方法诊断乳腺疾病的曲线下面积(AUC)分别为 0.749[95%置信区间(CI)0.650~0.848]、0.875(95%CI 0.798~0.952)、0.914(95%CI 0.851~0.976).BMRI-AP、BMRI-FDP的平均扫描时间分别为478(10)s、926(28)s,差异有统计学意义(Z=-12.94,P<0.001).结论 BMRI-AP作为一种高效、快速的检查方法,在未降低诊断效能的前提下,明显缩短了扫描时间、改善患者检查的舒适性,有望成为一种新的乳腺癌筛查方式.Objectivee To analyze the value of breast magnetic resonance imaging-abbreviated protocol(BMRI-AP)for supplementary screening in dense glands.Methods A total of 112 patients with dense glands,who had underwent further breast magentic resonance imaging(BMRI)scanning due to abnormal mammography screening,were selected.The diagnostic efficacy was compared via X^(2)test(Bonferroni correction)among mammography,BMRI-AP and breast magnetic resonance imaging full diagnostic protocol(BMRI-FDP),and receiver operating characteristic(ROC)curve was further drawn to analyze the diagnostic efficacy among these three methods.The Mann-Whitney U test was used for analysis due to the scanning time of BMRI-AP and BMRI-FDP without normal distribution.Results The diagnostic accuracy of mammography,BMRI-AP and BMRI-FDP was 75.89%,88.39%and 91.07%(X^(2)=11.607,P=0.003),respectively.There was no significant difference in diagnostic accuracy between BMRI-AP and BMRI-FDP(X^(2)=0.436,P=0.509).However,there were statistically significant differences in diagnostic accuracy between mammography and BMRI-AP as well as mammography and BMRI-FDP(X^(2)=5.965,P=0.015;X^(2)=9.356,P=0.002,respectively).The area under the curve(AUC)of mammography,BMRI-AP and BMRI-FDP for diagnosis of breast diseases were 0.749[95%confidence interval(CI)0.650-0.848],0.875(95%CI 0.798-0.952)and 0.914(95%CI 0.851-0.976),respectively.The average scanning time of BMRI-AP and BMRIFDP was 478(10)s and 926(28)s,and there was statistically significant difference in the average scanning time between BMRI-AP and BMRI-FDP(Z=-12.94,P<0.001).Conclusion BMRI-AP,as an efficient and rapid examination method,can significantly shorten the scanning time and improvethe examination comfort of patients without reducing the diagnostic performance,which is expected to become a new method for screening in patient with breast cancer.

关 键 词：乳腺肿瘤 磁共振成像 简化序列 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]