DCE-MRI、多b值DWI结合CA153、CEA对乳腺癌及肿块型浆细胞性乳腺炎的鉴别诊断价值研究

The Differential Diagnosis Value of DCEMRI,Multi-b Value DWI Combined with CA153 and CEA in Breast Cancer and Lumpy Plasma Cell Mastitis

目的探讨动态增强磁共振成像(DCE-MRI)、多b值扩散加权成像(DWI)结合糖类抗原(CA)153、癌胚抗原(CEA)对乳腺癌及肿块型浆细胞性乳腺炎(PCM)的鉴别诊断价值。方法回顾性分析2018年4月-2021年10月我院经病理检查证实的55例乳腺癌及48例肿块型PCM患者的临床资料。比较乳腺癌及肿块型PCM的MRI形态学表现。比较乳腺癌及肿块型PCM的DCE-MRI、多b值DWI参数。比较不同b值对乳腺癌、肿块型PCM的诊断效能。比较乳腺癌及肿块型PCM患者的血清CA153、CEA水平。探讨DCE-MRI、多b值DWI结合CA153、CEA对乳腺癌及肿块型PCM的鉴别诊断价值。结果乳腺癌与肿块型PCM在病灶边缘、有无导管扩张、强化方式及TIC曲线类型方面差异均有统计学意义(P<0.05)。乳腺癌患者转运常数(K_(trans))、速率常数(K_(ep))值均比肿块型PCM患者更高(P<0.05)。在相同b值时,乳腺癌的ADC值均低于肿块型PCM(P<0.05)。乳腺癌、肿块型PCM的诊断效能在b值为1000s/mm^(2)时最佳。乳腺癌患者血清CA153、CEA表达水平均高于肿块型PCM患者(P<0.05)。DCE-MRI、多b值DWI结合CA153、CEA对乳腺癌及肿块型PCM的鉴别诊断价值优于单独应用DCE-MRI、多b值DWI、CA153、CEA。结论DCE-MRI、多b值DWI、CA153、CEA均可用于鉴别诊断肿块型PCM和乳腺癌,联合应用可显著提高其鉴别诊断价值。

Objective To explore the differential diagnostic value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI),multi-b value diffusion weighted imaging(DWI)combined with carbohydrate antigen(CA)153 and carcinoembryonic antigen(CEA)on breast cancer and lumpy plasma cell mastitis(PCM).Methods The clinical data of 55 patients with breast cancer and 48 patients with lumpy PCM confirmed by pathological examination in our hospital from April 2018 to October 2021 were retrospectively analyzed.The MRI morphological features of breast cancer and lumpy PCM were compared.The DCE-MRI and multi-b value DWI parameters of breast cancer and lumpy PCM were compared.To compare the diagnostic performance of different b values for breast cancer and lumpy PCM.Serum CA153 and CEA levels were compared in breast cancer patients and lumpy PCM patients.To explore the differential diagnosis value of DCE-MRI,multi-b value DWI combined with CA153 and CEA in breast cancer and lumpy PCM.Results There were significant differences between breast cancer and lumpy type PCM in lesion margin,ductal dilatation,enhancement mode and tic curve type(P<0.05).The values of transport constant(K_(trans))and rate constant(K_(ep))in breast cancer patients were higher than those in lumpy PCM patients(P<0.05).At the same b value,the ADC value of breast cancer was lower than that of lumpy PCM(P<0.05).The diagnostic efficiency of breast cancer and lumpy PCM is the best when b value is 1000s/mm^(2).The expression levels of serum CA153 and CEA in breast cancer patients were higher than those in lumpy PCM patients(P<0.05).the differential diagnosis value of DCE-MRI,multi-b DWI combined with CA153 and CEA for breast cancer and lumpy type PCM was superior to that of DCE-MRI,multi-b DWI,CA153 and CEA alone.Conclusion DCE-MRI,multi-b value DWI,CA153 and CEA can all be used for differential diagnosis of lumpy PCM and breast cancer,combined application can significantly improve their differential diagnosis value.