MRI直方图结合TIC曲线鉴别乳腺纤维腺瘤与浸润性导管癌的价值

Value of MR histogram combined with TIC in differential diagnosis of breast fibroadenoma and invasive ductal carcinoma

目的:探讨MRI直方图和动态增强TIC曲线联合应用在鉴别乳腺纤维腺瘤与浸润性导管癌中的价值。方法:回顾性分析我院经手术病理证实的15例乳腺纤维腺瘤患者及32例浸润性导管癌患者的资料,所有患者均行乳腺MRI平扫及动态增强扫描。分别绘制TIC曲线及测量病变区直方图参数,包括均值、方差值、偏度值、峰度值、第10百分位数、第50百分位数、第90百分位数。使用SPSS 22.0统计分析软件分别用χ2检验和独立样本t检验比较乳腺纤维腺瘤与浸润性导管癌参数之间的差异。结果:TIC曲线在两者间有统计学差异(P<0.05)。直方图参数中峰度值在动态增强扫描第3期中存在明显统计学差异(P<0.01),相关性分析发现均值与方差值在增强扫描第1期、第3期及T2WI呈正相关(P<0.01),峰度值与偏度值在各序列呈强负相关(P<0.01)。两种方法联合诊断可以提高乳腺浸润性导管癌的敏感度及特异度。结论:MRI直方图和动态增强TIC曲线联合应用对鉴别诊断乳腺纤维腺瘤与浸润性导管癌有意义。

Objective: To investigate the value of combination of MRI histogram and dynamic enhanced TIC in the differential diagnosis of breast fibroadenoma and invasive ductal carcinoma. Methods: A retrospective analysis of 15 cases of breast fibroadenoma confirmed by surgery and pathology in our hospital and 32 cases of invasive ductal carcinoma were performed.All patients underwent breast MRI and dynamic contrast-enhanced scanning. We plotted the TIC and measure the histogram parameters of the lesion, including mean, variance, skewness, kurtosis, and 10 th, 50 th, 90 th percentiles. The differences between breast fibroadenoma and invasive ductal carcinoma parameters were compared using the χ2 test and the independent sample t test using SPSS 22.0 statistical analysis software. Results: The TIC was statistically different between the two groups(P<0.05). The kurtosis values in the histogram parameters were statistically significant(P<0.01) in the third phase of dynamic contrast-enhanced scanning. The correlation analysis found that the mean and variance values were strongly positively correlated in the first, third phases of the enhanced scan and T2 sequence(P<0.01), the kurtosis value and the skewness value were strongly negatively correlated in each sequence(P<0.01). The combined diagnosis of the two methods can improve the sensitivity and specificity of breast invasive ductal carcinoma. Conclusion: The combined diagnosis of MRI histogram and dynamic enhanced TIC curve is useful for the differential diagnosis of breast fibroadenoma and invasive ductal carcinoma.