多模态磁共振成像诊断乳腺环形强化病变

发布时间：2018-04-22 09:09

本文选题：乳腺疾病 + 磁共振成像　；参考：《中国医学影像技术》2017年11期

【摘要】：目的探讨多模态MRI对动态增强扫描(DCE)表现为环形强化的乳腺病变的诊断价值。方法回顾性分析经手术病理证实的67例乳腺病变患者的DCE-MRI、DWI资料,病灶DCE-MRI均表现为环形强化。根据病理结果将67例分为良性组和恶性组,比较2组DCE-MRI病灶整体形态学指标、"强化环"形态学指标、时间-信号强度曲线类型、DWI扩散受限分布位置指标、DCE-MRI半定量参数指标及"强化环"多点ADC值的差异。以病理结果为应变量,上述具有统计学差异的指标为自变量,建立Logisitc回归模型构建新的联合参数并评价其诊断效能。结果良、恶性组间"环形强化"环壁形态(χ~2=14.19,P=0.001)、是否具有壁结节(χ~2=12.48,P=0.001)、DWI扩散受限分布位置指标(χ~2=19.60,P=0.003)差异均有统计学意义;且2组间早期强化率(t=2.35,P=0.02),峰值达峰时间(T_(max);t=-4.66,P=0.007),ADC_(环内)(t=1.35,P=0.001)、ADC_(环壁)值(t=-2.88,P=0.005)差异均有统计学意义。新构建"强化环"形态学指标+DWI扩散受限分布位置+T_(max)+ADC_(环内)参数联合诊断乳腺病变性质的约登指数最高为0.83,ROC曲线下面积为0.87[95%CI(0.82,,0.91)],诊断敏感度及特异度分别为91.96%和91.31%。结论乳腺MR多模态成像对乳腺环形强化病变具有较高的诊断效能。
[Abstract]:Objective to investigate the value of multimodal MRI in diagnosing breast lesions with circular enhancement. Methods the DCE-MRIWI findings of 67 patients with breast lesions confirmed by surgery and pathology were retrospectively analyzed. The DCE-MRI of the lesions showed ring enhancement. According to the pathological results, 67 cases were divided into benign group and malignant group. The overall morphologic index and "enhanced ring" morphological index of DCE-MRI lesions were compared between the two groups. The type of time-signal intensity curve and the difference of DCE-MRI semi-quantitative parameter index and "enhanced ring" multi-point ADC value. Taking the pathological results as dependent variables and the above indexes with statistical differences as independent variables, a Logisitc regression model was established to construct new combined parameters and to evaluate their diagnostic effectiveness. Results there were significant differences between benign and malignant groups in "ring enhancement" (蠂 ~ 2 ~ 2 ~ (14) ~ (19) / P ~ (0.001) P ~ (0.001)) and whether there was a wall nodule (蠂 ~ (2) ~ (2) ~ (12.48) / P ~ (0.001)) DWI diffusion-limited distribution index (蠂 ~ (2) ~ (2) ~ (19.60) / P ~ (0.003)). In addition, there were significant differences in the early enhancement rate and peak peak time between the two groups (t = 2.35, P ~ (0.001)), and the peak peak time was (t) ~ (max) ~ (-4.66) / P ~ (0.007) / ADCS / (t = 1.35 / P ~ (0.001), t ~ (-2.88) / P ~ (0.005)). The newly constructed "enhanced ring" morphological index, DWI diffusion-limited distribution location (Tstack max.) ADCC parameters combined to diagnose the nature of breast lesions, the highest Yorden index was 0.87 (95CI0.82% 0.91), the diagnostic sensitivity and specificity were 91.96% and 91.31%, respectively.The results showed that the diagnostic sensitivity and specificity were 91.96% and 91.31%, respectively. Conclusion multimodal Mr imaging is effective in the diagnosis of ring-enhanced breast lesions.
【作者单位】：胜利油田中心医院磁共振检查科;胜利油田中心医院;
【分类号】：R445.2;R737.9

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