磁共振动态增强扫描联合弥散加权成像在乳腺病变良恶性鉴别中的应用价值探析

Exploration of the application value of dynamic contrast-enhanced magnetic resonance imaging combined with diffusion-weighted imaging in the differentiation of benign and malignant breast lesions

目的:分析磁共振动态增强扫描(DCE-MRI)联合弥散加权成像(DWI)鉴别乳腺病变良恶性的价值。方法:选取2021年10月—2023年10月蒙阴县人民医院收治的118例乳腺病变患者为研究对象,均行DCE-MRI、DWI检查,以病理检查结果为金标准分析DCEMRI联合DWI诊断乳腺病变良恶性的效能,对比良恶性乳腺病变影像学参数及影像学特征。结果:病理检查结果显示,118例乳腺病变患者恶性61例、良性57例。以病理检查结果为金标准,DCE-MRI检出恶性51例,DWI检出恶性52例,DCE-MRI联合DWI检出恶性60例。DCE-MRI联合DWI诊断乳腺病变良恶性的灵敏度、准确率、阴性预测值高于两者单独诊断(P<0.05);DCE-MRI联合DWI同病理检查诊断乳腺病变良恶性的一致性极好(Kappa值=0.949);恶性乳腺病变速率常数(Kep)、容积转运常数(Ktrans)高于良性病变,表观弥散系数(ADC)低于良性病变;恶性乳腺病变患者边界模糊、形状不规则、内部强化不均匀、早期强化>100%占比高于良性病变患者(P<0.05)。结论:DCE-MRI联合DWI能够诊断出乳腺病变良恶性,具有一定的诊断价值,值得临床借鉴。

Objective To analyze the value of dynamic enhanced magnetic resonance scanning(DCE-MRI)combined with diffusion-weighted imaging(DWI)in differentiating benign and malignant breast lesions.Methods A total of 118 patients with breast lesions admitted to the Mengyin County People's Hospital from October 2021 to October 2023 were selected as the research objects.All patients underwent DCE-MRI and DWI examination.The pathological findings were used as the gold standard to analyze the efficacy of DCE-MRI combined with DWI in the diagnosis of benign and malignant breast lesions,and the imaging parameters and imaging characteristics of benign and malignant breast lesions were compared.Results The results of pathological examination showed that 61 of 118 breast lesions were malignant and 57 were benign.Using the pathological findings as the gold standard,51 cases were detected malignant by DCE-MRI,52 cases malignant by DWI,and 60 cases malignant by DCE-MRI combined with DWI.The sensitivity,accuracy and negative predictive value of DCE-MRI combined with DWI in the diagnosis of benign and malignant breast lesions were higher than those of DCE-MRI and DWI alone(P<0.05).DCE-MRI combined with DWI showed excellent consistency with pathological examination in the diagnosis of benign and malignant breast lesions(Kappa=0.949).The rate constant(Kep)and volume transport constant(Ktrans)of malignant breast lesions were higher than those of benign breast lesions,and the apparent diffusion coefficient(ADC)was lower than that of benign breast lesions.The proportion of patients with malignant breast lesions with blurred boundary,irregular shape,uneven internal reinforcement and early reinforcement>100%was higher than those with benign lesions(P<0.05).Conclusion DCE-MRI combined with DWI can diagnose benign and malignant breast lesions,which has certain diagnostic value and is worthy of clinical reference.