动态增强磁共振联合扩散加权成像技术在乳腺环形强化病变的诊断价值分析
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摘要
目的探究动态增强磁共振联合扩散加权成像技术在乳腺环形强化病变的诊断价值。方法方便选取2016年7月—2018年1月60例乳腺环形强化病变患者为研究对象,根据病变性质分为良性病变组和恶性病变组,统计动态增强MRI征象及扩散加权成像参数,比较两组第一分钟强化率、EER、Tmax水平及"环形强化"多点ADC值。以病理结果为因变量,建立Logisitc回归模型构建新的联合参数并评价其诊断效能。结果两组整体形态(χ2=5.242,P=0.026)、整体边缘(χ2=7.341,P=0.008)、周围有无供血血管(χ2=4.214,P=0.003)、强化环环壁形态(χ2=8.961,P=0.004)、病变侧乳腺血管增多增粗(χ2=6.148,P=0.006)、壁结节(χ2=12.413,P=0.000)、TIC曲线(χ2=4.620,P=0.037)及DWI扩散受限分布位置(χ2=4.326,P=0.040)比较差异有统计学意义(P<0.05);良性病变组第一分钟强化率、EER、Tmax水平分别为(51.48±15.27)%、(84.68±52.64)%、(129.07±60.36)s,"环形强化"多点ADC值环内、环周、环壁值分别为(1.08±0.31)×10-3mm2/s、(1.22±0.30)×10-3mm2/s、(1.39±0.35)×10-3mm2/s,与恶性病变组比较差异有统计学意义(P<0.05);DCE-MRI+DWI模型诊断准确度均高于DCE-MRI和DWI模型,其敏感性、特异性和符合率分别为94.12%、79.41%和85.29%。结论动态增强磁共振联合扩散加权成像技术能明显提高乳腺环形强化病变的定性诊断价值。
Objective To investigate the diagnostic value of dynamic contrast-enhanced magnetic resonance combined with diffusion-weighted imaging in the treatment of ring-shaped lesions in the breast. Methods 60 patients with breast ring-shaped lesions from July 2016 to January 2018 were convenient selected enrolled. According to the nature of the lesions,they were divided into benign lesion group and malignant lesion group. Statistical dynamic enhanced MRI signs and diffusion-weighted imaging parameters were compared. One-minute enhancement rate, EER, Tmax level and "ring enhancement" multi-point ADC value. Using the pathological results as the dependent variable, a Logisitc regression model was established to construct new joint parameters and evaluate its diagnostic efficacy. Results The overall morphology of the two groups(χ2=5.242, P=0.026), the overall margin(χ2=7.314, P=0.008), the presence or absence of blood supply vessels(χ2=4.214, P=0.003), and the shape of the reinforced ring wall(χ2= 8.961, P=0.004), vascular enlargement and thickening of the lesion side(χ2=6.148, P =0.006), wall nodules(χ2=12.413, P =0.000), TIC curve(χ2=4.620, P =0.037) and DWI of diffusion-limited distribution position(χ2=4.326, P =0.040) was statistically significant(P <0.05). The first minute enhancement rate, EER and Tmaxlevels of benign lesion group were(51.48±15.27)%,(84.68±52.64)%,(129.07±60.36) s, "ringenhanced" multi-point ADC value in the ring, cycle, and ring wall values are(1.08±0.31)×10-3 mm2/s,(1.22±0.30)×10-3 mm2/s,(1.39±0.35)×10-3 mm2/s, the difference was statistically significant compared with the malignant lesion group(P<0.05); the diagnostic accuracy of the DCE-MRI +DWI model was higher than DCE-MRI and the sensitivity, specificity and coincidence rate of the DWI model were 94.12%, 79.41% and 85.29%, respectively. Conclusion Dynamic contrast-enhanced magnetic resonance combined with diffusion-weighted imaging can significantly improve the qualitative diagnostic value of mammary ring-shaped lesions.
Objective To investigate the diagnostic value of dynamic contrast-enhanced magnetic resonance combined with diffusion-weighted imaging in the treatment of ring-shaped lesions in the breast. Methods 60 patients with breast ring-shaped lesions from July 2016 to January 2018 were convenient selected enrolled. According to the nature of the lesions,they were divided into benign lesion group and malignant lesion group. Statistical dynamic enhanced MRI signs and diffusion-weighted imaging parameters were compared. One-minute enhancement rate, EER, Tmax level and "ring enhancement" multi-point ADC value. Using the pathological results as the dependent variable, a Logisitc regression model was established to construct new joint parameters and evaluate its diagnostic efficacy. Results The overall morphology of the two groups(χ2=5.242, P=0.026), the overall margin(χ2=7.314, P=0.008), the presence or absence of blood supply vessels(χ2=4.214, P=0.003), and the shape of the reinforced ring wall(χ2= 8.961, P=0.004), vascular enlargement and thickening of the lesion side(χ2=6.148, P =0.006), wall nodules(χ2=12.413, P =0.000), TIC curve(χ2=4.620, P =0.037) and DWI of diffusion-limited distribution position(χ2=4.326, P =0.040) was statistically significant(P <0.05). The first minute enhancement rate, EER and Tmaxlevels of benign lesion group were(51.48±15.27)%,(84.68±52.64)%,(129.07±60.36) s, "ringenhanced" multi-point ADC value in the ring, cycle, and ring wall values are(1.08±0.31)×10-3 mm2/s,(1.22±0.30)×10-3 mm2/s,(1.39±0.35)×10-3 mm2/s, the difference was statistically significant compared with the malignant lesion group(P<0.05); the diagnostic accuracy of the DCE-MRI +DWI model was higher than DCE-MRI and the sensitivity, specificity and coincidence rate of the DWI model were 94.12%, 79.41% and 85.29%, respectively. Conclusion Dynamic contrast-enhanced magnetic resonance combined with diffusion-weighted imaging can significantly improve the qualitative diagnostic value of mammary ring-shaped lesions.
引文
[1]李瑞敏,顾雅佳,彭卫军,等.定量动态增强磁共振评估乳腺癌新辅助化疗疗效的应用研究[J].中国癌症杂志,2016,26(7):623-628.
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[8]陈萍,田红岸,何金,等.动态增强磁共振成像及磁共振质子波谱分析联合诊断在乳腺良恶性肿瘤诊断中的价值[J].实用临床医药杂志,2017,21(23):126-128.
[9]郑海澜,严志汉,林洁,等.动态增强磁共振成像在112例乳腺肿瘤患者诊疗中的应用[J].中国临床医生杂志,2017,45(6):33-36.
[10]靳雅楠,张焱,程敬亮,等.DCE-MRI及DWI在鉴别乳腺良、恶性病变中的价值[J].郑州大学学报:医学版,2016,51(4):530-533.
[11]马寅锋,吕伯东,黄晓军,等.磁共振功能成像诊断中央区前列腺癌的临床应用价值探讨[J].浙江医学,2016,38(7):482-484.
[12]俞敏秋,李俊晨.对比增强能谱成像与动态增强磁共振成像诊断乳腺癌的对比研究[J].中国医疗设备,2017,32(11):74-77.
[2]朱蓉蓉,丁婕,黄宁,等.定量动态增强磁共振在乳腺肿块样腺病中的应用价值[J].实用放射学杂志,2016(2):208-211.
[3]张鑫,闵智乾,雷晓燕,等.MR动态增强MIP技术在乳腺疾病良恶性鉴别中的应用[J].实用放射学杂志,2018,34(1):35-38.
[4]郭轶,何成,魏淼,等.乳腺癌组织的动态增强磁共振参数与癌细胞增殖及侵袭的相关性研究[J].海南医学院学报,2017,23(11):1530-1533.
[5]阳君,苏丹柯,赵欣,等.动态增强磁共振联合扩散加权成像技术对乳腺环形强化病变的诊断应用价值研究[J].临床放射学杂志,2016,35(10):1490-1494.
[6]张秋妹,苗重昌.磁共振扩散加权与动态增强成像在子宫内膜癌中的应用与新进展[J].磁共振成像,2017,8(7):551-555.
[7]孟欣,任瑞美.动态增强磁共振与乳腺癌分子亚型血管生成的相关性研究[J].中华肿瘤防治杂志,2016,23(12):806-811,815.
[8]陈萍,田红岸,何金,等.动态增强磁共振成像及磁共振质子波谱分析联合诊断在乳腺良恶性肿瘤诊断中的价值[J].实用临床医药杂志,2017,21(23):126-128.
[9]郑海澜,严志汉,林洁,等.动态增强磁共振成像在112例乳腺肿瘤患者诊疗中的应用[J].中国临床医生杂志,2017,45(6):33-36.
[10]靳雅楠,张焱,程敬亮,等.DCE-MRI及DWI在鉴别乳腺良、恶性病变中的价值[J].郑州大学学报:医学版,2016,51(4):530-533.
[11]马寅锋,吕伯东,黄晓军,等.磁共振功能成像诊断中央区前列腺癌的临床应用价值探讨[J].浙江医学,2016,38(7):482-484.
[12]俞敏秋,李俊晨.对比增强能谱成像与动态增强磁共振成像诊断乳腺癌的对比研究[J].中国医疗设备,2017,32(11):74-77.