MRI动态对比增强时间-信号强度曲线与弥散加权成像表观弥散系数检查对乳腺良恶性病变的鉴别诊断价值  

Differential diagnostic value of MRI dynamic contrast enhanced time-signal intensity curve and diffusion weighted imaging apparent diffusion coeffecient in benign and malignant breast lesions

作　　者：王良敏 魏红霞 龚雪 WANG Liangmin;WEI Hongxia;GONG Xue(Department of Radiology,Nanyang Second General Hospital,Nanyang 473000,He’nan,China)

机构地区：[1]南阳市第二人民医院放射科,河南南阳4730000

出　　处：《癌症进展》2024年第15期1652-1654,1683,共4页Oncology Progress

基　　金：河南省医学科技攻关计划联合共建项目(2018020984)。

摘　　要：目的 探讨MRI动态对比增强时间-信号强度曲线(DCE-TIC)与弥散加权成像表观弥散系数(DWIADC)检查对乳腺良恶性病变的鉴别诊断价值。方法 106例乳腺占位性病变患者均行DCE-TIC、DWI-ADC检查,根据检查结果分为乳腺良性病变和乳腺癌患者,比较乳腺良性病变和乳腺癌患者的ADC值、rADC、TIC分型。以病理检查结果为金标准,分析DCE-TIC、DWI-ADC单独及联合检查对乳腺癌的诊断价值。结果 病理检查结果显示,106例乳腺占位性病变患者中,乳腺癌87例,乳腺良性病变19例。乳腺良性病变患者ADC值、rADC均明显高于乳腺癌患者,差异均有统计学意义(P﹤0.01)。乳腺良性病变TIC分型Ⅰ型患者比例明显高于乳腺癌,TIC分型Ⅲ型患者比例明显低于乳腺癌,差异均有统计学意义(P﹤0.01)。乳腺良性病变与乳腺癌TIC分型Ⅱ型患者比例比较,差异无统计学意义(P﹥0.05)。DCE-TIC、DWI-ADC联合检查诊断乳腺癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于二者单独检查。结论 DCE-TIC、DWI-ADC联合检查诊断乳腺癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于二者单独检查,诊断效能良好。Objective To investigate the differential diagnostic value of MRI dynamic contrast enhanced time-signal intensity curve(DCE-TIC)and diffusion weighted imaging apparent diffusion coeffecient(DWI-ADC)in benign and ma-lignant breast lesions.Method A total of 106 patients with breast space occupying lesions were examined by DCE-TIC and DWI-ADC.According to the examination results,they were divided into benign breast lesions patients and breast can-cer patients.The ADC values,rADC and TIC classification of patients with benign and malignant breast lesions were compared.Pathological examination results were used as the gold standard,the diagnostic value of DCE-TIC and DWI-ADC single and combined examinations in breast cancer were analyzed.Result Pathological examination results showed that among 106 patients with breast space occupying lesions,there were 87 cases of breast cancer and 19 cases of benign breast lesions.The ADC value and rADC in benign breast lesions patients were significantly higher than those in breast cancer patients,and the differences were statistically significant(P<0.01).The proportion of patients with TIC type I in benign breast lesions was significantly higher than that in breast cancer,the proportion of patients with TIC type III was significantly lower than that in breast cancer,and the differences were statistically significant(P<0.01).There was no significant difference in the proportion of patients with benign breast lesions and breast cancer with TIC type II(P>0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of DCE-TIC and DWI-ADC combined examination in the diagnosis of breast cancer were higher than those of single examination.Conclusion The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of DCE-TIC and DWI-ADC com-bined examination in the diagnosis of breast cancer are higher than those of single examination,and the diagnostic effica-cy is good.

关 键 词：乳腺癌 乳腺良性病变 MRI 动态对比增强时间-信号强度曲线 弥散加权成像表观弥散系数 鉴别诊断 

分 类 号：R737.9[医药卫生—肿瘤]