机构地区:[1]南京中医药大学附属常州市中医医院放射科,江苏常州213000
出 处:《实用放射学杂志》2024年第1期51-55,共5页Journal of Practical Radiology
基 金:常州市卫生健康委员会科技项目(WZ202207);常州市卫生健康青苗人才培养工程项目(CZQM2020082)。
摘 要:目的评估合成磁共振成像(syMRI)与小视野高分辨扩散加权成像(FOCUSDWI)对乳腺影像报告和数据系统(BI-RADS)4类乳腺良恶性病变的鉴别诊断价值。方法前瞻性分析行MRI检查归为BI-RADS4类的68例乳腺病变患者资料,其中良性病变31例(良性组),恶性病变37例(恶性组)。所有患者均行T_(1)WI、T_(2)WI、FOCUSDWI、动态对比增强磁共振成像(DCE-MRI)及syMRI扫描。由2位放射诊断医师分别在syMRI定量参数图及FOCUSDWI生成的表观扩散系数(ADC)图上勾画感兴趣区(ROI),测量得到相应的T_(1)、T_(2)、质子密度(PD)、ADC值。采用受试者工作特征(ROC)曲线评价syMRI与FOCUSDWI参数的阈值及诊断效能,通过二元logistic回归分析将2个序列参数进行联合并评估其诊断效能。结果乳腺恶性组的T_(2)、PD、ADC值明显低于良性组(P<0.05),T_(1)值组间差异无统计学意义(P>0.05)。T_(2)、ADC值可以作为诊断BI-RADS4类乳腺恶性病变的重要参考指标,曲线下面积(AUC)分别为0.833、0.867,差异无统计学意义(Z=0.485,P=0.627)。T_(2)值联合ADC值的AUC为0.910,敏感度、特异度分别为90.3%、89.2%。结论syMRI定量参数T_(2)值和FOCUSDWI的ADC值均能有效鉴别BI-RADS4类乳腺良恶性病变,将T_(2)值与ADC值联合能进一步提高鉴别诊断效能。Objective To evaluate the differential diagnostic value of synthetic magnetic resonance imaging(syMRI)and field of view optimized and constrained undistorted single shot diffusion weighted imaging(FOCUS DWI)in patient with breast imaging reporting and data system(BI-RADS)4 breast lesions.Methods A total of 68 patients who underwent breast MRI and were classified as BI-RADS category 4 were prospectively enrolled.Among them,there were 31 cases of benign lesions(benign group)and 37 cases of malignant lesions(malignant group).All patients underwent T_(1)WI,T_(2)WI,FOCUS DWI,dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and syMRI.Two radiologists delineated the region of interest(ROI)on quantitative parameters images of syMRI and the apparent diffusion coefficient(ADC)images generated from FOCUS DWI and calculated T_(1),T_(2),proton density(PD)and ADC values,respectively.The thresholds and diagnostic efficacy of syMRI and FOCUS DWI parameters were evaluated by the receiver operating characteristic(ROC)curve.Logistic regression analysis was used to combine the parameters of the two sequences and evaluate the diagnostic efficacy.Results The T_(2),PD,and ADC values in the malignant group were significantly lower than those in the benign group(P<0.05),but there were no statistically significant difference in T_(1)values between the groups(P>0.05).T_(2)and ADC values could be used as important diagnostic indexes in patient with malignant lesions of BI-RADS 4 breast lesions,and the area under the curve(AUC)of T_(2)and ADC was 0.833 and 0.867,respectively.There was no significant difference in AUC of T_(2)and ADC between benign and malignant groups(Z=0.485,P=0.627).The AUC of T_(2)value combined with ADC value was 0.910,and the sensitivity and specificity was 90.3%and 89.2%,respectively.Conclusion T_(2)value of syMRI and ADC value of FOCUS DWI can be used as quantitative diagnostic indicators in patients with BI-RADS 4 breast lesions.The combination of T_(2)and ADC values can further improve the differential d
关 键 词:小视野高分辨扩散加权成像 合成磁共振成像 乳腺肿瘤
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]
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