磁共振多序列成像对乳腺癌诊断及组织学分级的研究

Diagnostic value of1H-MRS combined with DCE and DWI in the diagnosis and histological grading of breast cancer

目的 探讨分析磁共振氢质子波谱(~1H-MRS)联合动态增强扫描(DCE)及扩散加权成像(DWI)在乳腺癌患者诊断及病理组织学分级判断中的诊断价值研究。方法 选取2022年3月至2023年5月于本院行乳腺3.0T磁共振检查后1周内手术治疗的92例患者,所有患者均获得术后病理证实。分析~1H-MRSCho峰、DCE-TIC和DWI-ADC表现,以患者术后病理诊断结果为金标准,评价诊断结果与病理诊断的一致性,分析~1H-MRSCho峰联合DCE-TIC和DWI-ADC在乳腺良恶性病变及不同组织分级乳腺癌诊断中的价值。结果 92例患者均经过病理学检查,包括乳腺癌62例和乳腺良性病变30例。~1H-MRSCho峰联合DCE-TIC和DWI-ADC对乳腺良恶性病变及不同组织分级乳腺癌进行诊断,其诊断准确率分别为89.13%和90.32%、敏感度为90.32%和100%、特异度为86.67%和84.62%,均显著高于~1H-MRSCho峰联合DCETIC和~1H-MRSCho峰联合DWI-ADC的相关指标(P<0.05)。结论~1H-MRSCho峰联合DCE-TIC和DWI-ADC能够显著提高在乳腺良恶性病变及不同组织分级乳腺癌诊断中的效能,可作为鉴别乳腺良恶性病变及乳腺癌不同组织分级的重要指标。

Objective To investigate the diagnostic value of analyzing magnetic resonance hydrogen proton spectroscopy(~1H-MRS) combined with dynamic enhancement scanning(DCE) and diffusion-weighted imaging(DWI) in the diagnosis and pathological histological grading of breast cancer.Methods 92 patients with breast cancer and operated within 1 week after 3.0T MRI of the breast in our hospital from March 2022 to May 2023 were selected,and postoperative pathological confirmation was obtained in all patients.The ~1H-MRS Cho peak,DCE-TIC and DWI-ADC manifestations were analyzed,and the consistency of the diagnostic findings with the pathological diagnosis was evaluated using the patients' postoperative pathological findings as the gold standard,and the value of ~1H-MRS Cho peak combined with DCE-TIC and DWI-ADC in the diagnosis of benign and malignant breast lesions and breast cancer of different tissue grades was analyzed.Results The diagnostic accuracy of ~1H-MRS Cho peak combined with DCE-TIC and DWI-ADC was 89.13% and 90.32%,sensitivity was 90.32% and 100%,and specificity was 86.67% and 84.62%,re-spectively.The diagnostic accuracy was 89.13% and 90.32%,sensitivity was 90.32% and 100%,and specificity was 86.67% and 84.62%,all of which were significantly higher than those associated with ~1H-MRS Cho peak combined with DCE-TIC and ~1H-MRS Cho peak combined with DWI-ADC(P<0.05).Conclusion The ~1H-MRS Cho peak combined with DCE-TIC and DWI-ADC can significantly improve the efficacy in the diagnosis of benign and malignant breast lesions and different tissue grades of breast cancer,and can be used as an important indicator to identify benign and ma-lignant breast lesions and different tissue grades of breast cancer.