高场磁共振1H-MRS在乳腺肿瘤定性诊断中的临床应用价值

目的 探讨高场磁共振1 H-MRS在乳腺肿瘤定性诊断中的临床应用价值及影响因素.方法 收集我院经手术病理或穿刺活检病理证实的乳腺肿瘤患者160例,共计172个肿瘤作为研究组,其中乳腺癌93个,良性肿瘤79个.全部病例均于术前行磁共振动态增强后1 H-MRS检查,回顾性分析本组病例的1 H-MRS表现及MRI诊断,并将MRI诊断结果与病理结果进行对比分析.结果 93个乳腺癌病灶中78个出现胆碱(Choline,Cho)峰.79个良性肿瘤中6个出现Cho峰.以3.23ppm处出现Cho峰(SNR≥2)为乳腺癌的诊断标准,其诊断的敏感性为83.9％,特异性为92.4％,准确率为87.8％,阳性预测值为92.9％,阴性预测值为83.0％.结论 高场磁共振1 H-MRS对乳腺癌的诊断敏感性和特异性较高,在乳腺肿瘤的定性诊断中有重要应用价值.

The clinical value of 1H-MRS in diagnosing breast tumours

Objective To evaluate the clinical applications of 1 H-MRS with high-field magnetic resonance imaging system in the diagnosis of breast tumor. Methods Retrospective analysis was performed on 172 Breast tumors （93 malignant, 79 benign） which had a specific pathological results. The 1 H-MRS features of them was sludied. The results of 1 H-MRS and the pathology of them were compared respectively. Results 78 items appeared Cho peak at 3.23 ppm （SNR≥2） in 93 malignant lesions. 6 items appearsed Cbo peak at 3.22 ppm （SNR≥2） in 79 benign lesions. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of Cho peak on differentiate benign from malignant lesions were 83.9 %, 92.4 %, 87.8 % ,92.9% and 83.0%, respectively. Conclusion 1 H-MRS has high diagnostic sensitivity and specificity for breast tumours. The 1 H-MRS is useful in qualitative diagnosis of breast tumours.