1.5T磁共振动态增强曲线联合DWI、血清CEA用于乳腺癌诊断的临床价值

The Clinical Value of 1.5T MRI Dynamic Enhancement Curve Combined with DWI and Serum CEA in the Diagnosis of Breast Cancer

目的分析1.5T磁共振动态增强曲线联合DWI、血清CEA用于乳腺癌诊断的临床价值。方法选取2016年1月至2018年1月间湛江市第二人民医院及广东医科大学附属医院收治的69例乳腺癌作为观察组及57例乳腺良性病变患者作为对照组;使用1.5T磁共振对患者进行扫描,分析患者动态增强曲线及DWI图像,并检测血清中CEA,以病理学诊断作为金标准分析各指标分析价值。结果观察组时间-强度曲线以Ⅲ型为主,对照组以Ⅰ型为主,且差异存统计学意义(P<0.05);观察组患者ADC值显著低于对照组(P<0.05),观察组患者血清中CEA水平显著高于对照组(P<0.05);时间-强化曲线诊断的阳性共75例,DWI扫描诊断的阳性共75例,CEA检测诊断的阳性共78例,平行联合诊断的阳性共87例,系列联合诊断的阳性共63例;系列联合诊断的特异度为95.24%显著高于各指标单独及平行联合诊断(P<0.05),采用平行联合诊断的灵敏度为100%显著高于各指标单独及系列诊断(P<0.05),且系列联合诊断的准确率90.48%及曲线下面积0.951显著高于各指标单独及平行诊断(P<0.05)。结论 1.5T磁共振动态增强曲线联合DWI、血清CEA对乳腺癌进行诊断时,可有效提高诊断准确率,具有较高的临床应用价值。

Objective To analyze the clinical value of 1.5 T MRI Dynamic enhancement curve combined with DWI and serum CEA in the diagnosis of breast cancer. Methods In 69 cases of breast cancer from January 2016 to January 2018 in Zhanjiang Second People＇s Hospital and affiliated hospital of Guangdong medical university as the observation group and 57 cases of benign breast disease patients as the control group; the patients were scanned using a 1.5 T magnetic resonance imaging instrument, analysis curve and DWI image enhancement with dynamic, and detection of serum CEA, the pathological diagnosis as gold the standard analysis of each index value analysis. Results A series of combined diagnostic specificity of 95.24% was significantly higher than that of each index alone and parallel combined diagnosis（P〈0.05）, the sensitivity of parallel combined diagnosis was 100% significantly higher than that of single and series of diagnostic indexes（P〈0.05）, and the accuracy rate was 90.48% and the area under the curve series combined diagnosis of 0.951 was significantly higher than that of each index alone and parallel diagnosis（P〈0.05）. Conclusion 1.5 T dynamic contrast-enhanced curve combined with DWI and serum CEA can improve the accuracy of diagnosis for breast cancer, and has high clinical application value.