摘要
目的:探讨联合应用MRI血流动力学半定量分析及囊壁形态学特征对乳腺良恶性囊实性病变的诊断价值。方法:回顾性选取75例乳腺良恶性囊实性病变患者的影像资料,对比分析良恶性囊实性病变囊壁的形态、厚度及壁结节;由MRI增强扫描图像获得时间-信号强度曲线(time-signal intensity curve,TIC),计算血流动力学半定量参数(达峰时间Tmax、早期强化率Ee、最大相对强化斜率Eslope、最大强化速率Vmax),对比良恶性病变间的差异,并绘制ROC曲线分析联合诊断效能。采用SPSS 19.0软件进行统计学分析。结果:良性囊实性病变大多内壁光滑,壁结节单发、形态规则;恶性囊实性病变内壁凹凸不平,壁结节多发、形态不规则;良性囊实性病变的壁厚小于恶性囊实性病变,差异有统计学意义(P<0.05)。乳腺囊实性病变强化方式以环形强化为主,良性病变TIC-Ⅰ型多见,恶性病变TIC-Ⅲ型多见;恶性病变的Ee、Eslope、Vmax均大于良性病变,恶性病变的达峰时间Tmax较良性病变短,差异均有统计学意义(P<0.05)。联合应用血流动力学半定量分析及囊壁形态学特征诊断乳腺良恶性囊实性病变的准确率、阳性预测值、阴性预测值、敏感度度、特异度分别为92.0%、95.1%、88.2%、90.1%、93.8%。结论:MRI血流动力学半定量分析及囊壁的形态学特征能够较好地鉴别乳腺囊实性病变的良恶性,二者联合分析有助于提高诊断效能。
Objective To explore the value of MRI hemodynamics semi-quantitative analysis combined with morphological characteristics of the cyst wall for diagnosing the cystic and solid lesions of breast.Methods The imaging data of 75 patients with benign and malignant cystic and solid lesions were selected retrospectively,and the benign and malignant cystic and solid lesions had the morphology,thickness and nodules of the walls compared and analyzed;the time-signal intensity curve(TIC)was obtained from the enhancement MRI images,the hemodynamic semi-quantitative parameters including time to peak(Tmax),early enhancement rate(Ee),maximum relative enhancement slope(Eslope)and maximum enhancement velocity(Vmax)were calculated,the benign and malignant lesions were compared and the ROC curve was plotted to analyze the diagnostic efficacy of MRI hemodynamics semi-quantitative analysis combined with morphological characteristics of the cyst wall.SPSS 19.0 software was used for statistical analysis.Results Most of the benign cystic lesions had smooth inner walls,single wall nodules and regular morphology characteristics,while the malignant cystic lesions had uneven inner walls,multiple wall nodules and irregular morphology characteristics;the wall thicknesses of benign cystic and solid lesions were lower than those of malignant lesions,and the differences were statistically significant(P<0.05).Most the breast cystic and solid lesions showed ring-shaped enhancement,and TIC-Ⅰtype was more common in benign lesions and TIC-Ⅲtype in malignant lesions;the malignant lesions had higher Ee,Eslope and Vmax and shorter Tmax when compared with the benign lesions,and the differences were all statistically significant(P<0.05).The accuracy,positive predictive value,negative predictive value,sensitivity and specificity of the combined hemodynamics semi-quantitative analysis and morphological characteristics of the cyst wall when used to diagnose benign and malignant cystic and solid lesions of the breast were 92.0%,95.1%,88.2%,90.1%,and 93.8%,respectively.Conclusion MRI hemodynamics semi-quantitative analysis and morphological characteristics of the cyst wall both can identify the benign and malignant cystic and solid lesions of breast,and their combination contributes to enhancing the diagnosis efficacy.
作者
黄俊珊
郏潜新
蔡宏杰
李金胜
许斯鼎
时昭胤
HUANG Jun-shan;JIA Qian-xin;CAI Hong-jie;LI Jin-sheng;XU Si-ding;SHI Zhao-yin(Department of Radiology,Zhangzhou Zhengxing Hospital,Zhangzhou 363000,Fujian Province,China)
出处
《医疗卫生装备》
CAS
2023年第2期66-70,共5页
Chinese Medical Equipment Journal
基金
漳州市自然科学基金项目(ZZ2020J020057)。
关键词
乳腺囊实性病变
乳腺病变
MRI
血流动力学
形态学特征
cystic and solid lesions of breast
breast lesion
MRI
hemodynamics
morphological characteristic
作者简介
黄俊珊(1985-),女,硕士研究生,主治医师,主要从事乳腺疾病诊断方面的研究工作,E-mail:huangjunshan@126.com;通信作者:郏潜新,E-mail:jiaqianxin@163.com。
