DWI+DCE-MRI对乳腺癌恶性病灶检出率的影响

Effect of DWI+DCE-MRI on the detection of malignant lesions in breast cancer

目的:探讨扩散加权成像(Diffusion weighted imaging,DWI)+动态增强磁共振成像(Dynamic enhanced-magnetic resonance imaging,DCE-MRI)对乳腺癌恶性病灶检出率的影响。方法:选取164例我院2018年6月至2020年6月就诊的疑似乳腺病变患者,所有患者均采用DWI、DCE-MRI进行检查,以手术病理检查结果为“金标准”,比较DWI、DCE-MRI单独及联合检查诊断结果、诊断效能及对不同类型乳腺癌恶性病变的检出率,并通过DWI检查比较良、恶性乳腺癌病灶表观扩散系数(Apparent diffusion coefficient,ADC)。结果:经DWI检查,阳性119例;经DCE-MRI检查,阳性121例;经联合检查,阳性136例;与DWI、DCE-MRI单独检查相比,联合检查灵敏度、准确率较高,漏诊率较低(P<0.05);与DWI、DCE-MRI单独检查相比,联合检查对于微浸润癌检出率较高(P<0.05);与良性病灶相比,当b=800s•mm-2、b=1000s•mm-2时恶性病灶ADC值较小(P<0.05)。结论:DWI+DCE-MRI检查诊断准确率显著高于单独检查,可有效提高诊断效能及对不同类型乳腺病变检出率,对临床早期筛查诊断、制定治疗方案具有重要意义。

Objective:To investigate the effect of diffusion weighted imaging(DWI)+dynamic enhanced-magnetic resonance imaging(DCE-MRI)on the detection of malignant lesions in breast cancer.Methods:A total of 164 patients with suspected breast lesions treated in our hospital from June 2018 to June 2020 were selected.All patients were examined by DWI and DCE-MRI.Based on the surgical pathological examination as the“gold standard”,the diagnostic results,diagnostic performance and detection rate of different types of breast cancer malignant lesions were examined by DEI,DCE-MRI or joint examination;and the apparent diffusion coefficient(ADC)of benign and malignant breast cancer lesions were compared by DWI.Results:119 cases were positive by DWI;121 cases were positive by DCE-MRI;136 cases were positive by combined examination.Compared with DWI or DCE-MRI,the combined examination had a higher sensitivity and accuracy,lower missed diagnosis rate(P<0.05);besides,the combined examination had a higher detection rate for microinvasive carcinoma(P<0.05).When b=800 s·mm^(-2) or b=1000 s·mm^(-2),the ADC value of malignant lesions was smaller than that of benign lesions(P<0.05).Conclusion:The diagnostic accuracy of DWI+DCE-MRI combined examination is significantly higher than that of either single examination;combined examination can effectively improve the diagnostic efficiency and the detection rate of different types of breast lesions,and is of great significance for early clinical screening and diagnosis and formulation of treatment plans.