3.0T单体素磁共振波谱成像对乳腺良恶性病变诊断的研究

A study on the clinical application of single voxel ~1H MR spectroscopy at 3.0T for differentiating benign and malignant breast lesions

目的探讨单体素磁共振波谱(MRS)在乳腺良恶性病变中的诊断效能。方法采用Siemens Magnetom Skyra 3.0 T磁共振对本院2016年3月～2017年1月61例女性患者(63个病灶)行单体素波谱扫描,使用半定量方法计算病灶I(Cho)/I(Water)比值,并由此计算出诊断的灵敏度及特异度。结果 63例病灶中,42例为恶性,21例为良性;病灶大小从0.9～9.4 cm不等。MRS半定量分析中恶性病灶I(Cho)/I(Water)比值范围为1～168.72(中位数为9.055,四分位数间距为35.85),良性病灶I(Cho)/I(Water)比值范围为0～10.6(中位数为0.98,四分位数间距为2.20),良恶性病灶之间差异具有统计学意义(P <0.05)。ROC曲线得出诊断临界值为2.44,MRS诊断的灵敏度、特异度、PPV、NPV及准确性分别为73.8﹪、81.0﹪、88.6﹪、60.7﹪及76.2﹪,AUC为0.853。结论磁共振波谱成像技术在乳腺良恶性病变诊断中具有一定的诊断价值。

Objective The aim of our study was to evaluate the effectiveness of single voxel 1H magnetic resonance spectroscopy （MRS） in differentiating benign and malignant breast lesions. Methods Single voxel 1H magnetic resonance spectroscopy （1H-MRS） was performed with a 3.0 T scanner on 61 women from March 2016 to May 2017. A semi-quantitative method was used to calculate the ratio of choline peak vs.water peak, sensitivity and specificity were calculated. Results In 63 cases, 42 cases were malignant, and the rest were benign. The size of lesions ranged from 0.9 to 9.4 cm. Semi quantitative MRS analysis showed that the ratio of choline peak vs.water peak, I （Cho）/I （Water）, ranges from 1 to 168.72 （median 9.055, four percentile interval is 35.85） in malignant lesions, while from 0 to 10.6 （median 0.98, four percentile interval is 2.20） in benign lesions, with significant differences between benign and malignant lesions （P 〈 0.05）. The ROC curve showed that the diagnostic critical value of 2.44, MRS diagnostic sensitivity, specificity, PPV, NPV and accuracy were 73.8 % , 81% , 88.6 % , 60.7 % and 76.2 % ,AUC was 0.853. Conclusion MRS has a high diagnostic accuracy in differentiating breast lesions.