多模态磁共振成像技术在乳腺病变诊断中的应用

目的探讨乳腺MR T1WI动态增强扫描结合DWI、T2*WI首过灌注成像在乳腺病变诊断中的意义。方法分析56例乳腺病变患者的T1WI动态增强时间-信号强度曲线(TIC)、ADC值及T2*WI首过灌注成像TIC,评估单一方法诊断与三者联合诊断的效能。结果将T1WI动态增强TIC为流出型的病变诊断为恶性,诊断的敏感性为87.0%,特异性为66.7%。弥散敏感系数(b)=1 000 s/mm2时,以ADC<1.18×10-3 mm2/s作为诊断乳腺恶性病变的阈值,ROC曲线下面积为0.859,敏感性为85.7%、特异性为83.3%。以T2*WI首过灌注最大信号强度下降率20%作为诊断恶性病变的阈值,敏感性为83.3%,特异性为92.9%。T1WI动态增强扫描、ADC值、T2*WI首过灌注成像及三者联合应用的诊断正确预测百分比分别为79.3%、79.3%、87.9%及89.7%。结论 T1WI动态增强扫描结合DWI、T2*WI首过灌注成像有助于乳腺良恶性病变的定性诊断。

Multimodal MRI technology in the diagnosis of breast lesions

Objective To explore the breast MR dynamic enhancement T1 WI scanning combining DWI, T2＊WI first perfusion imaging in the diagnosis of breast lesions. Methods By analyzing T1 WI dynamic enhanced time-signal intensity curve（TIC）, ADC values and T2＊WI first perfusion TIC of 56 cases with breast lesions, evaluated the effectiveness of single diagnosis and combined diagnosis. Results As TIC of T1 WI dynamic enhancement were outflow sharp lesions would be considered to be malignant, the sensitivity of diagnosis was 87.0%, specificity was 66.7%. When b=1 000 s/mm^2, ADC values〈1.18×10^-3mm^2/s was as threshold value of diagnosis of malignant breast lesions, the area under the ROC curve was 0.859, the sensitivity was 85.7%, specificity was 83.3%. As similar to, maximum signal strength decline rate 20% of T2＊WI first perfusion as threshold value of diagnosis of malignant lesion, sensitivity was 83.3%, specificity was 92.9%. Diagnosis correctly predicted percentage of dynamic enhanced T1 WI TIC, ADC values, T2＊WI first perfusion TIC and combined application of all were respectively 79.3%, 79.3%, 87.9% and 89.7%. Conclusion Dynamic enhanced T1 WI scan with DWI, T2＊WI first perfusion imaging can help the qualitative diagnosis of benign and malignant breast lesions.