多模态MRI对乳腺良恶性病变的鉴别诊断研究  

Differential diagnosis of benign and malignant breast lesions by multimodal MRI

作　　者：孙丽波 史胜军 SUN Libo;SHI Shengjun(Department of Imaging,Linyi Cancer Hospital,Linyi,Shandong 276037,China;Department of Radiology,Linyi Shangcheng Hospital,Linyi,Shandong 276003,China)

机构地区：[1]临沂市肿瘤医院影像科,山东临沂276037 [2]临沂商城医院放射科,山东临沂276003

出　　处：《影像研究与医学应用》2024年第9期18-21,共4页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨多模态磁共振(MRI)检查对乳腺良恶性病变的诊断价值及效果。方法:选取临沂市肿瘤医院2020年6月—2023年4月收治的乳腺病变患者200例为研究对象,所有患者均采用飞利浦Ingenia 3.0T磁共振、8通道乳腺专用线圈完成患者平扫、磁共振动态增强(DCE-MRI)扫描和弥散加权成像(DWI)检查,参考ACR BI-RADS-MRI完成乳腺良恶性病变的解读、诊断及分级,并以病理结果为“金标准”,分析多模态MRI对乳腺良恶性病变患者中的诊断鉴别效果。结果:200例乳腺病变患者经“金标准”检查确诊恶性病变56例(占28.00%)、良性病变142例(占72.00%)。MRI平扫检查恶性28例,DCE-MRI检查恶性48例,DWI检查恶性53例,多模态MRI检查恶性56例;金标准下恶性患者MRI检查下DWI扫描序列ADC值、EADC值低于良性患者(P<0.05);恶性患者Tmax低于良性患者(P<0.05);MSI及SER水平高于良性(P<0.05);多模态MRI用于乳腺良恶性病变鉴别中准确度、灵敏度、阳性和阴性预测值均高于单一扫描检查结果(P<0.05)。结论:多模态MRI用于乳腺良恶性病变鉴别中效果显著,能清晰地显示病变形态、血供及细胞代谢水平差异,具有典型的影像学特点。Objective To explore the diagnostic value and effectiveness of multimodal magnetic resonance imaging(MRI)in the diagnosis of benign and malignant breast lesions.Methods 200 patients with breast lesions at Linyi Cancer Hospital from June 2020 to April 2023 were selected as the study subjects.All patients underwent Philips Ingenia 3.0T magnetic resonance imaging,8-channel breast specific coils,and underwent plain scan,dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI),and diffusion-weighted imaging(DWI)examinations.ACR BI-RADS-MRI was used to interpret,diagnose,and grade breast benign and malignant lesions,and pathological results were used as the"gold standard"to analyze the diagnostic and differential effects of multimodal MRI in patients with breast benign and malignant lesions.Results Among the 200 cases,56 were diagnosed with malignant lesions(28.00%)and 142 were diagnosed with benign lesions(72.00%)through the"gold standard"examination.28 cases of malignancy were detected by MRI plain scan,48 cases by DCE-MRI,53 cases by DWI,and 56 cases by multimodal MRI.Under the gold standard,the ADC and EADC values of DWI scan sequences in malignant patients were lower than those in benign patients(P<0.05)during MRI examination.The Tmax of malignant patients was lower than that of benign patients(P<0.05).The levels of MSI and SER were higher than those of benign(P<0.05).The accuracy,sensitivity,positive and negative predictive values of multimodal MRI in distinguishing benign and malignant breast lesions were higher than those of single scan examination results(P<0.05).Conclusion Multimodal MRI has a significant effect in distinguishing benign and malignant breast lesions,and can clearly display differences in lesion morphology,blood supply,and cellular metabolism levels,with typical imaging characteristics.

关 键 词：多模态核磁共振 磁共振动态增强 弥散加权成像 病理结果 鉴别诊断 乳腺良恶性病变 

分 类 号：R445.2[医药卫生—影像医学与核医学]