基于磁共振多模态成像定量参数鉴别诊断乳腺良恶性病变及与临床病理特征的关系探究  

Differential Diagnosis of Benign and Malignant Breast Lesions Based on Quantitative Parameters of Magnetic Resonance Multimodal Imaging and Its Relationship with Clinicopathological Features

作　　者：徐静[1] 马光辉 刘彭华[1] 王勇刚[1] 田志勇 XU Jing;MA Guang-hui;LIU Peng-hua;WANG Yong-gang;TIAN Zhi-yong(CT Room of the First Hospital of Handan City,Handan 056002,Hebei Province,China)

机构地区：[1]邯郸市第一医院CT室,河北邯郸056002

出　　处：《中国CT和MRI杂志》2024年第3期93-96,共4页Chinese Journal of CT and MRI

摘　　要：目的 分析磁共振多模态成像定量参数鉴别诊断乳腺良恶性病变的价值,并探究乳腺病变性质与临床病理特征的关系。方法 纳入2015年1月-2022年12月医院120例乳腺占位性病变患者,所有患者入院时均接受磁共振多模态成像检查,包括弥散加权(DWI)、磁共振波谱成像(MRS)与磁共振动态增强(DCE-MRI),以病理检查结果为“金标准”,分析该检查方式鉴别诊断乳腺良恶性病变的价值。依据乳腺占位性病变性质将患者分为恶性组与良性组,对比两组临床病理特征,分析乳腺病变性质与临床病理特征的关系。结果 120例乳腺占位性病变患者经病理检查结果显示,乳腺癌98例(81.67%),乳腺良性病变22例(18.33%);以病理检查结果为“金标准”,DCE-MRI及联合诊断乳腺病变性质的灵敏度、准确度高于DWI(P<0.05);乳腺癌组表观扩散系数(ADC)、rADC值低于乳腺良性病变组,Ⅰ型TIC曲线占比低于乳腺良性病变组,Ⅲ型TIC曲线占比高于乳腺良性病变组(P<0.05);绘制ROC曲线,结果显示,ADC、rADC及TIC曲线类型诊断乳腺病变性质具有一定价值(AUC=0.815、0.850、0.911);乳腺癌组肿瘤形态不规则、边缘毛刺/不规则、强化不均匀占比高于乳腺良性病变组(P<0.05);经Logistic回归分析,结果显示,肿瘤临床病理特征与乳腺占位性病变密切相关,形态不规则、边缘毛刺/不规则、强化不均匀是乳腺癌的危险因素(OR>1,P<0.05)。结论磁共振多模态成像定量参数对乳腺良恶性病变具有一定鉴别诊断价值,乳腺癌的发生与肿瘤形态不规则、边缘毛刺/不规则、强化不均匀等临床病理特征密切相关。Objective To analyze the value of quantitative parameters of magnetic resonance multimodal imaging in differential diagnosis of benign and malignant breast lesions,and to explore the relationship between the nature of breast lesions and clinicopathological features.Methods One hundred and twenty patients with breast occupying lesions in our hospital from January 2015 to December 2022 were enrolled.All patients underwent MR multimodal imaging examination,including diffusion-weighted imaging(DWI),magnetic resonance spectroscopy(MRS)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI).Taking pathological examination results as the"gold standard",the value of this examination method in differential diagnosis of benign and malignant breast lesions was analyzed.According to the nature of breast space-occupying lesions,patients were divided into malignant group and benign group,and the clinicopathological features of the two groups were compared to analyze the relationship between the nature of breast lesions and clinicopathological features.Results The pathological examination of 120 patients with breast occupying lesions showed that 98 cases were breast cancer(81.67%)and 22 cases were benign breast lesions(18.33%).Taking pathological examination results as the"gold standard",the sensitivity and accuracy of DCE-MRI and combined diagnosis of breast lesions were higher than that of DWI(P<0.05).The apparent diffusion coefficient(ADC)and rADC values of breast cancer group were lower than those of benign breast lesions group,and the proportion of typeⅠTIC curve was lower than that of benign breast lesions group,and the proportion of typeⅢTIC curve was higher than that of benign breast lesions group(P<0.05).The ROC curve was drawn.The results showed that ADC,rADC and TIC curve types had certain value in diagnosing the nature of breast lesions(AUC=0.815,0.850,0.911).The proportion of irregular tumor shape,irregular fringe and uneven enhancement in breast cancer group was higher than that in benign breast lesi

关 键 词：乳腺良占位性病变 磁共振多模态成像 鉴别诊断 临床病理特征 

分 类 号：R445.2[医药卫生—影像医学与核医学]