MRI动态增强与SWI技术对乳腺肿瘤良恶性的诊断鉴别价值

目的探讨磁共振成像动态增强扫描(DCEMRI)和磁敏感加权成像(SWI)序列对乳腺肿瘤良、恶性的诊断鉴别价值。方法选取2017年1月至2018年12月于本院收治的76例乳腺疾病患者入组,对入组患者的76枚乳腺内病变均行DCE-MRI和SWI检查,对图像进行综合分析并诊断乳腺肿瘤的良、恶性,比较两种检查方法的影像表现和诊断结果;同时行活组织病理检查,计算两种检查方法的敏感度、特异度、准确率、阳性预测值、阴性预测值和kappa值。结果76例乳腺疾病患者中,经病理学诊断确诊35例(46.05%)为良性肿瘤,41例(53.95%)为恶性肿瘤。DCE-MRI诊断乳腺肿瘤良、恶性的灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为88.57%、92.68%、90.79%、91.18%和90.48%均显著高于SWI检查的68.57%、70.73%、69.74%、66.67%和72.50%,P<0.05,且DCE-MRI诊断的kappa值为0.814,大于SWI诊断的Kappa值0.392。结论DCE-MRI诊断乳腺肿瘤良、恶性的灵敏度、特异度、准确率较高,与病理学诊断结果具有较高的一致性,有较高的临床应用价值,而SWI诊断相比DCE-MRI诊断无显著临床优势。

Differential Diagnosis Value of MRI Dynamic Enhancement and SWI Technique for Benign and Malignant Breast Tumor

Objective To explore differential diagnosis value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and susceptibility-weighted imaging(sWI)sequence for benign and malignant breast tumors.Methods 76 patients with breast disease admitted to the hospital from January 2017 to December 2018 were enrolled.All underwent DCE-MRI and sWI.The images were synthetically analyzed.The benign and malignant breast tumors were diagnosed.The imaging findings and diagnostic results of the two methods were compared.At the same time,a biopsy was performed.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and kappa value of the two methods were statistically analyzed.Results Of 76 patients with breast diseases,35(46.05%)cases were confirmed with benign tumors by pathological diagnosis,and 41(53.95%)cases with malignant tumors.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of DCE-MRI for diagnosis of benign and malignant breast tumors were 88.57%,92.68%,90.79%,91.18%,and 90.48%,respectively,which were significantly higher than those of sWI(68.57%,70.73%,69.74%,66.67%,72.50%)(P<0.05).The kappa value of DCE-MRI diagnosis was greater than that of sWI(0.814 vs.0.392).Conclusion The sensitivity,specificity,and accuracy of DCE-MRI are higher in diagnosing benign and malignant breast tumors,which is highly consistent with those of pathological diagnosis,with high clinical application value.However,there is no significant clinical advantage of sWI diagnosis compared with DCE-MRI.