MR频谱参数与DWI在乳腺良恶性病变诊断中的应用

Application of MR Spectral Parameters and DWI in the Diagnosis of Benign and Malignant Breast Lesions

目的探讨氢质子磁共振频谱(1H-MRS)与扩散加权成像(DWI)在乳腺良恶性病变诊断中的应用。方法选取2016年1月至2019年1月期间在本院经病理学确诊的62例乳腺疾病患者,共87个病灶,良性病灶31个,恶性病灶56个。患者均行常规磁共振成像(MRI)、1H-MRS和DWI扫描,观察胆碱(Cho)出现情况,测量ADC值。以病理结果为金标准,分析1H-MRS和DWI诊断价值。结果56个恶性病灶中有45个出现Cho峰,31个良性病灶中有1个出现Cho峰,恶性病灶Cho峰出现率高于良性病灶,差异有统计学意义(P<0.05);恶性病灶ADC平均值为(0.93±0.16)×10-3mm2/s,良性病灶ADC平均值为(1.42±0.35)×10-3 mm2/s,恶性病灶ADC平均值低于良性病灶,差异有统计学意义(P<0.05);经受试者工作特诊曲线分析,1H-MRS诊断灵敏度和特异度分别为0.804和0.968,DWI诊断灵敏度和特异度分别为0.801和0.946。结论1H-MRS和DWI诊断乳腺良恶性病变均有较高特异度,具有一定应用价值。

Objective To investigate the application of proton magnetic resonance spectroscopy(1 H-MRS)and diffusion-weighted imaging(DWI)in the diagnosis of benign and malignant breast lesions.Methods A total of 62 patients with breast disease diagnosed by pathology in the hospital from January 2016 to January 2019 were enrolled.There were 87 lesions,including 31 benign lesions and 56 malignant lesions.All patients underwent routine magnetic resonance imaging(MRI),1 H-MRS,and DWI scan.The occurrence of choline(Cho)was observed.ADC values were measured.In order to evaluate the diagnostic value of 1 H-MRS and DWI,a comparison with the pathology gold standard was performed.The diagnostic value of 1 H-MRS and DWI was analyzed.Results Among the 56 malignant lesions,there were 45 cases with Cho peak.Among the 31 benign lesions,there wasone case with Cho peak.The occurrence rate of Cho peak in malignant lesions was higher than that in benign lesions(P<0.05).The mean value of ADC in malignant lesions was lower than that in benign lesions[(0.93±0.16)×10-3 mm2/s VS(1.42±0.35)×10-3 mm2/s](P<0.05).The receiver operator characteristic curve(ROC)showed that the diagnostic sensitivity and specificity of 1 H-MRS were 0.804 and 0.968,respectively.The above twoindexes of DWI were 0.801 and 0.946,respectively.Conclusion There is a relatively higher specificity of 1 H-MRS and DWI for the diagnosis of benign and malignant breast lesions,which is of certain application value.