联合应用1H—MRS与MR动态增强成像诊断乳腺肿瘤

Diagnosis of breast tumors with 1H-MRS and dynamic contrast-enhanced magnetic resonance imaging

目的比较应用MR动态增强成像(DCE-MRI)与联合应用1 H-MRS及DCE-MRI对乳腺肿瘤的诊断价值。方法回顾性分析50例乳腺肿瘤患者的1 H-MRS及DCE-MRI表现,包括恶性肿瘤33例,良性肿瘤17例,并与病理及临床随诊结果进行对比。对所有患者分别行常规扫描、1 H-MRS扫描及注射对比剂后动态增强扫描,分析时间-信号曲线(TIC)类型和胆碱(Cho)峰的显示情况。结果以TIC类型判断肿瘤的良恶性,诊断的敏感度为100%(33/33),特异度为58.82%(10/17),准确率为66.00%(33/50);应用1 H-MRS联合DCE-MRI诊断的敏感度为100%(33/33),特异度为88.24%(15/17),准确率为96.00%(48/50),与单纯DCE-MRI诊断的特异度和准确率差异有统计学意义(P均<0.02)。结论 DCE-MRI诊断乳腺肿瘤的特异度和准确率较低。1 H-MRS与DCE-MRI联合应用可提高对乳腺肿瘤的诊断准确率。

Objective To compare the value of dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） alone and combined with 1 H-MRS in diagnosis of breast tumors. Methods 1 H-MRS and DCE-MRI of 50 patients with breast tumors including 33 malignant lesions and 17 benign lesions were retrospectively analyzed. The diagnostic results of 1H- MRS and DCE-MRI were compared with pathological and clinical follow-up results. All patients underwent pre-enhanced conventional scanning, 1 H-MRS scanning and DCE-MR scanning after injection of contrast agent. The type of time-intensity curves （TIC） and display of choline （Cho） peak for all lesions were calculated. Results The diagnostic sensitivity, specificity and accuracy rate for TIC alone was 100% （33/33）, 58. 82% （10/17） and 66.00% （33/50）, respectively, while was 100% （33/33）, 88. 24% （15/17） and 96.00% （48/50） respectively for combined application of 1H-MRS and DCEMRI. There was statistical difference in diagnostic specificity and accuracy rate between the two methods （both P〈0.02）. Conclusion DCE-MRI has lower specificity and aceuracy rate for diagnosis of breast tumors. Combination of 1 H-MRS and DCE-MRI can improve the diagnostic accuracy rate of breast tumors.