动态增强磁共振联合扩散加权成像技术在乳腺环形强化病变的诊断价值分析

Diagnostic Value of Dynamic Contrast-enhanced Magnetic Resonance and Diffusion-weighted Imaging in the Treatment of Ring-shaped Lesions in the Breast

目的探究动态增强磁共振联合扩散加权成像技术在乳腺环形强化病变的诊断价值。方法方便选取2016年7月—2018年1月60例乳腺环形强化病变患者为研究对象,根据病变性质分为良性病变组和恶性病变组,统计动态增强MRI征象及扩散加权成像参数,比较两组第一分钟强化率、EER、Tmax水平及"环形强化"多点ADC值。以病理结果为因变量,建立Logisitc回归模型构建新的联合参数并评价其诊断效能。结果两组整体形态(χ2=5.242,P=0.026)、整体边缘(χ2=7.341,P=0.008)、周围有无供血血管(χ2=4.214,P=0.003)、强化环环壁形态(χ2=8.961,P=0.004)、病变侧乳腺血管增多增粗(χ2=6.148,P=0.006)、壁结节(χ2=12.413,P=0.000)、TIC曲线(χ2=4.620,P=0.037)及DWI扩散受限分布位置(χ2=4.326,P=0.040)比较差异有统计学意义(P<0.05);良性病变组第一分钟强化率、EER、Tmax水平分别为(51.48±15.27)%、(84.68±52.64)%、(129.07±60.36)s,"环形强化"多点ADC值环内、环周、环壁值分别为(1.08±0.31)×10-3mm2/s、(1.22±0.30)×10-3mm2/s、(1.39±0.35)×10-3mm2/s,与恶性病变组比较差异有统计学意义(P<0.05);DCE-MRI+DWI模型诊断准确度均高于DCE-MRI和DWI模型,其敏感性、特异性和符合率分别为94.12%、79.41%和85.29%。结论动态增强磁共振联合扩散加权成像技术能明显提高乳腺环形强化病变的定性诊断价值。

Objective To investigate the diagnostic value of dynamic contrast-enhanced magnetic resonance combined with diffusion-weighted imaging in the treatment of ring-shaped lesions in the breast.Methods 60 patients with breast ring-shaped lesions from July 2016 to January 2018 were convenient selected enrolled.According to the nature of the lesions,they were divided into benign lesion group and malignant lesion group.Statistical dynamic enhanced MRI signs and diffusion-weighted imaging parameters were compared.One-minute enhancement rate,EER,Tmax level and "ring enhancement" multi-point ADC value.Using the pathological results as the dependent variable,a Logisitc regression model was established to construct new joint parameters and evaluate its diagnostic efficacy.Results The overall morphology of the two groups (χ^2=5.242,P=0.026),the overall margin (χ^2=7.314,P=0.008),the presence or absence of blood supply vessels (χ^2=4.214,P=0.003),and the shape of the reinforced ring wall (χ^2= 8.961,P=0.004),vascular enlargement and thickening of the lesion side (χ^2=6.148,P=0.006),wall nodules(χ^2=12.413,P=0.000),TIC curve (χ^2=4.620,P=0.037) and DWI of diffusion-limited distribution position (χ^2=4.326,P=0.040) was statistically significant (P<0.05).The first minute enhancement rate,EER and Tmax levels of benign lesion group were (51.48±15.27)%,(84.68±52.64)%,(129.07±60.36) s,“ring-enhanced” multi-point ADC value in the ring,cycle,and ring wall values are (1.08±0.31)×10-3mm2/s,(1.22±0.30)×10^-3mm^2/s,(1.39±0.35)×10^-3mm^2/s,the difference was statistically significant compared with the malignant lesion group (P<0.05);the diagnostic accuracy of the DCE-MRI+DWI model was higher than DCE-MRI and the sensitivity,specificity and coincidence rate of the DWI model were 94.12%,79.41% and 85.29%,respectively.Conclusion Dynamic contrast-enhanced magnetic resonance combined with diffusion-weighted imaging can significantly improve the qualitative diagnostic value of mammary ring-shaped lesions.