动态增强扫描结合多b值DWI成像对乳腺良恶性病变诊断的临床价值

Clinical Value of Dynamic Contrast Enhanced MRI Combined with Multi-b Value DWI Imaging in the Diagnosis of Benign and Malignant Breast Lesions

目的探究动态增强扫描(DCE-MRI)结合多b值弥散加权成像(DWI)成像对乳腺良恶性病变诊断的临床价值。方法选择2016年1月至2018年2月我院收治的乳腺肿块患者纳入研究,所有患者均行多b值DWI扫描及DCE-MRI检查,以病理结果为金标准,计算多b值DWI扫描、DCE-MRI及两者联合扫描诊断乳腺良恶性病变的灵敏度、特异度、准确性。结果当b值为500、800、1000s/mm2时,乳腺良性病变表观弥散系数(ADC)值显著高于恶性病变,差异具统计学意义(P<0.05);当b值为800s/mm2时,其诊断乳腺良恶性病变的曲线下面积最大,诊断灵敏度、特异度、准确性分别为81.3%、90.0%、84.6%;DCE-MRI扫描对良恶性乳腺疾病的诊断灵敏度、特异度、准确性分别为90.6%、75.0%、84.6%;两者联合诊断灵敏度、特异度、准确性分别为96.9%、100.0%、98.0%,联合诊断准确度显著高于单纯动态增强扫描及DWI成像(P<0.05)。结论DCE-MRI对乳腺良恶性病变具有较高的诊断灵敏度,DWI具有较高的特异度,两者联合诊断可有效提高乳腺癌诊断准确性。

Objective To investigate the clinical value of dynamic contrast-enhanced scanning(DCE-MRI)combined with multi-b-value diffusion-weighted imaging(DWI)imaging in the diagnosis of benign and malignant breast lesions.Methods Patients with breast mass admitted to our hospital from January 2016 to February 2018 were chosen for study.All patients was given multi-b-value DWI scan and DCE-MRI.Taking the pathological results as the gold standard,the multi-b-value DWI scan.The sensitivity,specificity and accuracy for the diagnosis of benign and malignant breast lesions by multi-b-value DWI scan,DCE-MRI and their combined scanning were calculated.Results When the b value equaled to 500,800,1000s/mm2,the apparent diffusion coefficient(ADC)value of benign breast lesions was significantly higher than that of malignant lesions(P<0.05);When b value equaled to 800s/mm2,the area under the curve by the diagnosis of benign and malignant breast lesions was the largest,the diagnostic sensitivity,specificity and accuracy were 81.3%,90.0%,and 84.6%,respectively.The sensitivity,specificity,and accuracy for benign and malignant breast diseases diagnosis by DCE-MRI scan were 90.6%,75.0%,and 84.6%,respectively.The above values were 96.9%,100.0%,and 98.0%,respectively by the combined diagnosis.The accuracy of combined diagnostic was significantly higher than that of simple dynamic contrast-enhanced scanning and DWI imaging(P<0.05).Conclusion DCE-MRI has higher diagnostic sensitivity for benign and malignant breast lesions,DWI has higher specificity.The combined diagnosis of both can effectively improve the diagnostic accuracy of breast cancer.