多模态磁共振在乳腺癌中的诊断价值

目的:研究在诊断乳腺癌多模态磁共振成像(MRI),包含动态增强成像(DCE-MRI)、MRI弥散加权成像(DWI)在乳腺癌中的诊断价值,探讨如何增加乳腺癌的确诊率。方法:选取2017年10月至2019年4月经我院乳腺外科确诊为占位性病变的60例患者为研究对象,于手术或穿刺活检前进行磁共振检查,选择常规磁共振序列、DWI、DCE-MRI三种方法对所有患者进行扫描。统计分析表观扩散系数(apparent diffusion coefficient,ADC),动态时间信号曲线(time intensity curves,TIC),以及相对表观扩散系数(rADC),随访患者病理结果并以此为金标准,将三种方法对鉴别乳腺良恶性肿物的准确度和灵敏度进行比较,选出判断乳腺癌良恶性的最优方法。结果:60例乳腺疾病患者中,28例为恶性病变,约占47%,32例为良性病变,占53%,最大直径约1.1~7.3cm;DCE-MRI检查的TIC曲线流出型为乳腺癌的诊断标准,敏感性为89.2%,特异性为77.2%;DWI磁敏感系数b=1000s/mm^2时,以ADC=1.02×10^-3作为诊断阈值,此时曲线下面积(ROC)最大为0.876,敏感性为82.3%,特异性为80.1%;DCE-MRI、DWI两者联合诊断乳腺癌敏感性和特异性分别为89.7%、84.5%。结论:DWI及DEC-MRI均能准确的区分乳腺疾病的良恶性,两者联合对乳腺疾病的定性诊断准确率最高。

Analysis on Diagnosis Value of Multi-modality NMR Imaging for Breast Cancer

Objective:to study the diagnostic value of multimodal magnetic resonance imaging((MRI),)including dynamic enhanced imaging(DCE-MRI),MRI diffusion-weighted imaging(DWI)in breast cancer,and to explore how to increase the diagnostic rate of breast cancer.Methods:from October 2017 to April 2019,60 patients with space-occupying lesions diagnosed by breast surgery in our hospital were selected as subjects.Magnetic resonance imaging(MRI)was performed before operation or puncture biopsy.routine magnetic resonance sequence(MRI)and DWI,DCE-MRI were used to scan all patients.Statistical analysis of apparent diffusion coefficient(app)Arent diffusion coefficient,(ADC),dynamic time signal curve(time intensity curves,TIC)and relative apparent diffusion coefficient((rADC),)were used as gold standard to compare the accuracy and sensitivity of the three methods in distinguishing benign and malignant breast tumors,and the optimal method for judging benign and malignant breast cancer was selected.Results:of the 60 patients with breast diseases,28(47%)were malignant lesions,32(53%)were benign lesions,and the maximum diameter was about 1.1%.When the TIC curve outflow type was 89.2%and the specificity was 77.2%≤DWI magnetic sensitivity coefficient b=1000 s/mm^2,ADC=1.02×10^-3 was used as the diagnostic threshold.The maximum area(ROC)under the curve was 0.876,the sensitivity was 82.3%,and the specificity was 80.1%.The sensitivity and specificity of DCE-MRI,DWI in the diagnosis of breast cancer were 89.7%and 84.5%,respectively.Conclusion:DWI and DEC-MRI can accurately distinguish breast.The combination of benign and malignant diseases has the highest accuracy in qualitative diagnosis of breast diseases.