磁共振扩散加权成像联合时间-信号强度曲线在诊断乳腺癌中的应用价值

摘要

目的 探讨磁共振扩散加权成像(DWI)联合时间-信号强度曲线(TIC)在诊断乳腺癌中的应用价值.方法 28例乳腺癌患者和25例乳腺良性病变患者均行DWI及磁共振动态增强(DCE-MRI)检查.比较乳腺良性病变和乳腺癌MRI动态增强的形态学特征,TIC曲线形态及分布,ADC值,两者联合诊断和单一诊断的敏感性、特异性和准确性.结果 乳腺良性病变MRI动态增强的形态主要以类圆形为主(76.0％),边缘以光滑(72.0％)为主,乳腺癌的形态主要以分叶形为主(60.7％),边缘以毛刺征(60.7％)为主,两组比较差异均有统计学意义(均P＜ 0.05);乳腺良性病变TIC曲线形态以Ⅰ型(68.0％)为主,恶性病变以Ⅲ型(78.6％)为主,两组比较差异有统计学意义(P＜0.05);78.6％乳腺癌ADC值≤1.22×10-3 mm2/s,80.0％乳腺良性病变ADC值＞1.22×10-3 mm2/s,两组比较差异有统计学意义(P＜0.05);两者联合诊断乳腺良恶性病变的敏感性、特异性及准确性均明显高于磁共振动态增强、扩散加权成像单一诊断(均P＜ 0.05).结论 DWI联合TIC诊断乳腺癌患者具有较高的临床价值.%Objective To study the application value of diffusion weighted imaging (DWI) combined with time-signal intensity curve (TIC) in the diagnosis of breast cancer.Methods 28 cases of breast cancer and 25 cases of breast benign lesions were performed DWI and DCE-MRI examination.The morphological features,TIC curve shape and distribution,ADC values of patients with breast benign lesions and breast cancer were compared.The sensitivity,specificity,and accuracy of combined diagnosis and single diagnosis were compared.Results The form of MRI dynamic enhancement in breast benign lesions was given priority to class round (76.0％),edge was given priority to smooth (72.0％),the form of breast cancer was given priority to leaf shape (60.7％),edge was given priority to burr indications (60.7％),with statistically significant differences between the two groups (P＜0.05).The TIC curve of breast benign lesions was given priority to Ⅰ type (68.0％),malignant lesions was given priority to Ⅲ type (78.6％),with statistically significant difference between the two groups (P＜0.05).ADC values of 78.6％ breast cancer were ≤ 1.22× 10-3 mm2/s,ADC values of 80.0％ breast benign lesions were ＞1.22× 10-3 mm2/s,with statistically significant difference between the two groups (P＜0.05).The sensitivity,specificity,and accuracy of both diagnosis of benign and malignant breast lesions were significantly higher than those of single dynamic enhanced magnetic resonance or diffusion weighted imaging diagnosis (P＜0.05).Conclusion DWI combined with TIC has a high clinical value in the diagnosis of breast cancer.