3.0T磁共振动态增强及波谱成像对乳腺癌定性诊断的价值简

目的：探讨3.0T磁共振动态增强扫描（DCE-MRI）与氢质子波谱（1H-MRS）成像在乳腺癌定性诊断中的临床应用价值。方法收集我院经手术后病理或穿刺活检病理证实的乳腺肿瘤患者78例，共计82个肿瘤作为研究组，其中乳腺癌54个，良性肿瘤28个。全部病例均于术前行磁共振动态增强后1H-MRS检查，回顾性分析本组病例的DCE-MRI及1H-MRS表现，并将MRI诊断结果与病理结果进行对比分析。统计学处理采用χ2检验等。结果 DCE-MRI检查单独诊断乳腺癌的敏感性为87％，特异性为71％，准确性为82％，阳性预测值为86%，阴性预测值为74%。1H-MRS检查单独诊断乳腺癌的敏感性为91％，特异性为86％，准确性为89％，阳性预测值为92%，阴性预测值为83%。DCE-MRI联合1H-MRS诊断乳腺癌的敏感性为98％，特异性为82％，准确性为93％。结论磁共振波谱与动态增强扫描单独诊断乳腺癌的敏感性及准确率较低，二者联合应用可明显提高其敏感性和诊断准确率，对乳腺癌的术前定性诊断有重要应用价值。

The clinical values of 1H-MRS and DCE-MRI in diagnosing breast cancer

Objective To evaluate the clinical values of 1H-MRS and DCE-magnetic resonance imaging （MRI） with 3.0T MRI system in the diagnosis of breast cancer. Methods Retrospective analysis on 82 breast tumors （54 malignant and 28 benign tumor） which were confirmed by pathological results. Study the features of 1H-MRS and DCE-MRI,and the results of 1H-MRS and DCE-MRI were compared with the pathology respectively. Chi-square test was adopted for statistics processing. Results The sensitivity, specificity , accuracy, positive predictive value and negative predictive value of time-signal intensity curve in diagnosing breast cancer were 87%, 71%, 82%, 86% and 74% respectively.While the sensitivity, specificity , accuracy, positive predictive value and negative predictive value of 1H-MRS in diagnosing breast cancer were 91%, 86%, 89%, 92%and 83%respectively. And the sensitivity, speci-ficity and accuracy of 1H-MRS associated with DCE-MRI in diagnosing breast cancer were 98%, 82%and 93%. Con-clusion The sensitivity is lower by only using 1H-MRS or DCE-MRI than that using 1H-MRS associated with DCE-MRI in diagnosing breast cancer. 1H-MRS associated with DCE-MRI is useful in qualitative diagnosis of breast cancer.