DCE-MRI与DWI在单纯DCIS和DCIS伴微浸润鉴别诊断中的应用

Application of DCE-MRI and DWI in the differential diagnosis of simple DCIS and DCIS with microinfiltration

目的探讨磁共振动态增强(Dynamic Contrast Enhanced MRI,DCE-MRI)与扩散加权成像(Diffusion weighted imaging,DWI)在单纯乳腺导管原位癌(Ductal carcinoma in situ,DCIS)和DCIS伴微浸润中的鉴别诊断价值。方法选取三门峡市中心医院磁共振科室2019年4月至2020年6月间收治的90例疑似DCIS患者作为研究对象,均行DCE-MRI、DWI和病理学检测。结果90例疑似患者中,经病理学检测出恶性84例,其中单纯DCIS为56例,DCIS伴微浸润为28例。DCE-MRI与DWI鉴别诊断DCIS的灵敏度为92.86%、特异度为66.67%、准确度为91.11%。经DCE-MRI与DWI鉴别诊断单纯DCIS与DCIS伴微浸润结果与病理学鉴别诊断结果具有极好一致性(Kappa=0.893)。结论DCE-MRI与DWI在单纯DCIS与DCIS伴微浸润鉴别诊断中具有较高准确度,且重复性好,诊断效能高。

Objective To investigate the differential diagnosis value of dynamic enhanced magnetic resonance(DCE-MRI)and diffusion-weighted imaging(DWI)in simple breast ductal carcinoma in situ(DCIS)and DCIS with micro-infiltration.Methods 90 suspected DCIS patients treated in Department of Magnetic Resonance,Sanmenxia Central Hospital from April 2019 to June 2020 were selected as the research subjects.They all underwent DCE-MRI and DWI,pathological examination.Results Among the 90 suspected patients,84 cases were malignant detected by pathology,including 56 cases of simple DCIS and 28 cases of DCIS with micro-infiltration.The sensitivity of DCE-MRI and DWI in the differential diagnosis of DCIS was 92.86%,specificity was 66.67%,and accuracy was 91.11%.The results of the differential diagnosis of simple DCIS and DCIS with micro-infiltration by DCE-MRI and DWI were significantly consistent with the results of the differential diagnosis of pathological differentiation(Kappa=0.893).Conclusion DCE-MRI and DWI have high accuracy in the diagnosis and differentiation of simple DCIS and DCIS with micro-invasion,with good repeatability and high diagnostic efficiency.