摘要
目的:探讨体素内不相关运动扩散加权成像(IVIM-DWI)对磁共振动态增强扫描(DCE-MRI)鉴别良、恶性乳腺非肿块样强化病变的辅助诊断效能。方法:回顾性分析56例呈非肿块样强化的乳腺病变的影像资料,分析病变在DCE-MRI上的特征和定量参数[病变分布特征、内部强化特点、TIC曲线、最大增强斜率(MSI)]及IVIM-DWI定量参数(f值、D值、D^*值)并进行良、恶性组间比较;建立单独应用DCE-MRI及DCE-MRI与IVIM-DWI联合应用的Logistic回归模型,评价其对良、恶性病变的鉴别诊断效能。结果:病变的分布特征、强化特点及TIC曲线类型在良、恶性组间的差异具有统计学意义(P<0.05);而MSI(恶性组:2.57、1.89;良性组:1.92、1.43)的组间差异无统计学意义(P>0.05);恶性组的f值(8.13±2.64)和D^*值(6.96±2.89)高于良性组(分别为6.92±2.56和6.83±2.58),D值低于良性组(恶性组:1.05±0.31;良性组:1.27±0.26),其中D^*和D值在两组间的差异有统计学意义(P<0.05)。两种回归模型诊断乳腺良、恶性病变的敏感度、特异度、符合率、阳性预测值和阴性预测值分别为88.24%、68.42%、81.13%、79.49%、80.75%及91.18%、73.68%、84.91%、83.35%、85.24%。结论:IVIM-DWI作为一种辅助检查方法能提高DCE-MRI检查对乳腺非肿块样强化病变的鉴别诊断效能,尤其是诊断特异性.
Objective:The purpose of this study was to investigate the value of use of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI) as an adjunct to dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) in distinguishing enhanced benign from malignant non-mass-like breast lesions.Methods:56 patients with non-mass-like breast lesions who underwent MRI examination were retrospective reviewed.The features and quantitative parameters of the lesions on DCE-MRI [distribution,enhancement characteristics,TIC curve and the maximum enhancement slope(MSI)] and quantitative parameters(f,D and D^*) on IVIM-DWI were observed and measured,and the differences between benign and malignant groups were compared and analyzed.Multivariate logistic regression was performed to identify variables that distinguished benign from malignant breast lesions.The pathology results were used as a gold standard to evaluate the the diagnostic performance of DCE-MRI and DCE-MRI plus IVIM-DWI.Results:The differences of distribution,enhancement characteristic and TIC curve between benign and malignant lesions were statistically significant(P<0.05);but there was no significant difference in MSI(malignant group:2.57 and 1.89;benign group:1.92 and 1.43).The values of f(malignant group:8.13±2.64;benign group:6.92±2.56) and D^*(malignant group:6.96±2.89;benign group:6.83±2.58) were higher in malignant group than those in benign group,and the values of D(malignant group:1.05±0.31;benign group:1.27±0.26) was the opposite(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the two regression models in diagnosis of benign and malignant breast lesions were as follows:88.24%,68.42%,81.13%,79.49%,80.75% and 91.18%,73.68%,84.91%,83.35%,85.24%.Conclusion:IVIM-DWI can significantly improve the diagnostic efficacy of DCE-MRI in the differential diagnosis of enhanced benign and malignant non-mass-like breast lesions,especially the diagnostic specificity.
作者
马德晶
逯峰
邹雪雪
陈亮
徐明露
范万峰
MA De-jing;LU Feng;ZOU Xue-xue(Binzhou Medical University Hospital,Shandong 256603,China)
出处
《放射学实践》
北大核心
2019年第12期1337-1342,共6页
Radiologic Practice
关键词
乳腺病变
非肿块样强化
体素内不相关运动
扩散加权成像
动态增强扫描
磁共振成像
Breast lesion
Non-mass-like enhanced
Intravoxel incoherent motion
Diffusion-weighted imaging
Dynamic contrast-enhanced
Magnetic resonance imaging
作者简介
马德晶(1984-),女,山东德州人,博士研究生,主治医师,主要从事中枢神经及乳腺影像诊断工作;通讯作者:范万峰,E-mail:byfyfwf@126.com。
