探讨3.0T MRI动态增强联合扩散加权成像对乳腺疾病的诊断价值
发布时间：2019-04-22 13:28
【摘要】：目的探讨3.0T磁共振动态增强扫描(Dynamic contrast-enhancedmagnetic resonance imaging, DCE-MRI)联合扩散加权成像（Diffusion-weighted imaging, DWI）在乳腺疾病中的诊断价值。 材料与方法应用8通道乳腺专用相控阵表面线圈，采用GE SignaHDx3.0T超导核磁共振扫描仪进行检查研究：①搜集2012年3月-2013年3月于我院就诊的乳腺疾病患者73例，共79个病灶，均为女性，均获得手术或病理结果证实。②所有患者依次行3.0T DWI横断面扫描、DCE-MRI扫描。行磁共振检查之前，，每位患者均签署知情同意书。分析所有病变形态、边缘情况、TIC类型，统计比较分别采用DCE-MRI中的Fischer评分、DWI中ADC阈值及两种扫描方式不同评分方法联合诊断乳腺良、恶性疾病的敏感度、特异度、准确度、阴性似然比及阳性似然比。 结果 1良、恶性病变的平均表观扩散系数（Apparent diffusioncoefficient， ADC）分别为(1.49±0.340)×10-3mm2/s和(1.01±0.277)×10-3mm2/s。 2根据受试者工作特性（Receiver operating characteristic, ROC）曲线确定ADC阈值为1.15×10-3mm2/s，其诊断的敏感度83.3%（35/42）、特异度83.8%（31/37）、准确度83.5%（66/79）、阴性似然比0.199、阳性似然比5.142。 3动态增强Fischer评分其敏感度为97.6%（41/42）、特异度为78.4%（29/37）、准确度为88.6%（70/79）、阴性似然比0.031、阳性似然比为4.519。 4两者扫描方式联合诊断的敏感度为92.9%（39/42）、特异度为91.9%（34/37）、准确度为92.4%（73/79）、阴性似然比为0.077、阳性似然比为11.469。 结论联合诊断方法较单一运用DCE-MRI或DWI在敏感度、特异度、准确度、阴性似然比及阳性似然比等指标上诊断效能强,在乳腺疾病诊断及鉴别诊断中具有较高的临床应用价值。
[Abstract]:Objective to evaluate the diagnostic value of 3.0T dynamic enhanced MRI (Dynamic contrast-enhancedmagnetic resonance imaging, DCE-MRI) combined with diffusion weighted imaging (Diffusion-weighted imaging, DWI) in breast diseases. Materials and methods the surface coil of 8-channel phasor array was used for the examination and study. The results were as follows: (1) 73 patients with breast diseases from March 2012 to March 2013, with 79 lesions, were collected from March 2012 to March 2013 in our hospital. All the patients were female and were confirmed by operation or pathology. 2 all patients underwent 3.0T DWI cross-sectional scan and DCE-MRI scan in turn. Prior to the MRI, each patient signed an informed consent. The sensitivity and specificity of Fischer score in DCE-MRI, ADC threshold in DWI and two different scanning methods in the diagnosis of benign and malignant diseases of breast were analyzed and compared with each other by analyzing the morphology, edge and TIC types of the lesions, and statistically comparing the sensitivity and specificity of the two scoring methods in the diagnosis of benign and malignant diseases of the breast. Accuracy, negative likelihood ratio and positive likelihood ratio. Results 1 the average apparent diffusion coefficient (Apparent diffusioncoefficient, ADC) of benign and malignant lesions was (1.49 卤0.340) 脳 10-3mm2/s and (1.01 卤0.277) 脳 10 脳 10 脳 3 mm ~ 2 vs (1.01 卤0.277) 脳 10 ~ (3) mm ~ (2) respectively. 2According to the (Receiver operating characteristic, ROC) curve, the threshold of ADC was determined to be 1.15 脳 10-3mm2 / s. The sensitivity, specificity and accuracy of ADC were 83.3% (35 / 42), 83.8% (31 / 37) and 83.5% (66 / 79), respectively, and the sensitivity, specificity and accuracy were 83.3%, 83.8% and 63.5%, respectively. The negative likelihood ratio is 0.199 and the positive likelihood ratio is 5.142. 3The sensitivity, specificity, accuracy, negative likelihood ratio and positive likelihood ratio of dynamic enhanced Fischer score were 97.6% (41 / 42), 78.4% (29 / 37), 88.6% (70 / 79), 0.031 and 4.519, respectively. 4the sensitivity, specificity, accuracy, negative likelihood ratio and positive likelihood ratio were 92.9% (39 / 42), 91.9% (34 / 37), 92.4% (73 / 79), 0.077 and 11.469 respectively. Conclusion the combined diagnostic method is more effective than DCE-MRI or DWI alone in sensitivity, specificity, accuracy, negative likelihood ratio and positive likelihood ratio. It has high clinical application value in the diagnosis and differential diagnosis of breast diseases.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2
本文编号：2462873
[Abstract]:Objective to evaluate the diagnostic value of 3.0T dynamic enhanced MRI (Dynamic contrast-enhancedmagnetic resonance imaging, DCE-MRI) combined with diffusion weighted imaging (Diffusion-weighted imaging, DWI) in breast diseases. Materials and methods the surface coil of 8-channel phasor array was used for the examination and study. The results were as follows: (1) 73 patients with breast diseases from March 2012 to March 2013, with 79 lesions, were collected from March 2012 to March 2013 in our hospital. All the patients were female and were confirmed by operation or pathology. 2 all patients underwent 3.0T DWI cross-sectional scan and DCE-MRI scan in turn. Prior to the MRI, each patient signed an informed consent. The sensitivity and specificity of Fischer score in DCE-MRI, ADC threshold in DWI and two different scanning methods in the diagnosis of benign and malignant diseases of breast were analyzed and compared with each other by analyzing the morphology, edge and TIC types of the lesions, and statistically comparing the sensitivity and specificity of the two scoring methods in the diagnosis of benign and malignant diseases of the breast. Accuracy, negative likelihood ratio and positive likelihood ratio. Results 1 the average apparent diffusion coefficient (Apparent diffusioncoefficient, ADC) of benign and malignant lesions was (1.49 卤0.340) 脳 10-3mm2/s and (1.01 卤0.277) 脳 10 脳 10 脳 3 mm ~ 2 vs (1.01 卤0.277) 脳 10 ~ (3) mm ~ (2) respectively. 2According to the (Receiver operating characteristic, ROC) curve, the threshold of ADC was determined to be 1.15 脳 10-3mm2 / s. The sensitivity, specificity and accuracy of ADC were 83.3% (35 / 42), 83.8% (31 / 37) and 83.5% (66 / 79), respectively, and the sensitivity, specificity and accuracy were 83.3%, 83.8% and 63.5%, respectively. The negative likelihood ratio is 0.199 and the positive likelihood ratio is 5.142. 3The sensitivity, specificity, accuracy, negative likelihood ratio and positive likelihood ratio of dynamic enhanced Fischer score were 97.6% (41 / 42), 78.4% (29 / 37), 88.6% (70 / 79), 0.031 and 4.519, respectively. 4the sensitivity, specificity, accuracy, negative likelihood ratio and positive likelihood ratio were 92.9% (39 / 42), 91.9% (34 / 37), 92.4% (73 / 79), 0.077 and 11.469 respectively. Conclusion the combined diagnostic method is more effective than DCE-MRI or DWI alone in sensitivity, specificity, accuracy, negative likelihood ratio and positive likelihood ratio. It has high clinical application value in the diagnosis and differential diagnosis of breast diseases.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2
【参考文献】
相关期刊论文 前4条
1 王远梅;陈昌毅;汪卫兵;黄劲柏;熊浩;雷红卫;;MRI扩散加权成像对乳腺良恶性病变的诊断[J];放射学实践;2012年06期
2 顾雅佳;冯晓源;唐峰;彭卫军;毛健;杨文涛;;乳腺肿瘤的MRI扩散特征及参数选定[J];中华放射学杂志;2007年05期
3 张峰;罗立民;鲍旭东;陈北京;;中国妇女乳腺X线钼靶摄影普查成本效益分析[J];肿瘤;2012年06期
4 赵希彤;么金龙;;扩散加权磁共振成像及表观扩散系数在肺癌组织学诊断中的作用[J];中国医科大学学报;2011年05期
本文编号：2462873
本文链接：https://www.wllwen.com/yixuelunwen/fangshe/2462873.html
