摘要
目的探讨3D酰胺质子转移加权成像(APTWI)及其联合动态增强扫描(DCE-MRI)对乳腺肿块样病变的鉴别诊断价值。方法回顾性分析DCE-MRI表现为肿块样病变且接受APTWI检查的140例患者,共140个肿块,所有肿块均经病理证实。用以下3种诊断方法区分病变的良恶性:基于DCE-MRI的乳腺影像报告和数据系统(BI-RADS);APTWI计算的MTRasym(3.5 ppm)定量评估值;DCE-MRI和APTWI联合诊断。Mann-Whitney U检验比较良恶性肿块间APTWI参数的差异,采用受试者工作特性曲线比较3种方法的诊断效能。结果DCE-MRI和APTWI均能用于区分乳腺良恶性肿块,其中DCE-MRI诊断的敏感性、特异性和准确性分别为100.0%、41.5%、72.9%,APTWI以MTRasym(3.5 ppm)等于2.8%为最佳临界值,诊断的敏感性、特异性和准确性分别为76.0%、70.8%、73.6%。DCE-MRI+APTWI鉴别乳腺肿块样病变的曲线下面积(0.877)大于DCE-MRI(0.813,P<0.05)和APTWI(0.796,P<0.05),诊断的敏感性、特异性和准确性分别达89.3%、86.1%、87.9%。DCE-MRI+APTWI对BI-RADS 4类肿块诊断的AUC显著大于DCE-MRI(0.90 vs 0.55,P<0.05)。结论APTWI与DCE-MRI结合,提高了对乳腺肿块样病变的诊断价值,尤其是对4类肿块的诊断准确性。
Objective To evaluate the diagnostic value of a combination of 3D amide proton transfer weighted imaging(APTWI)and dynamic contrast-enhanced scanning(DCE-MRI)for differentiation between benign and malignant breast masses.Methods From July 2020 to December 2020,140 patients who showed breast masses on DCE-MRI and underwent APTWI examination were analyzed retrospectively,including 140 masses,all of which were proved by pathology.All lesions were differentiated as benign or malignant using the following three diagnostic methods:the Breast Imaging–Reporting and Data System based on DCE-MRI;The quantitative evaluation value of MTRasym(3.5 ppm)calculated by APTWI;A combination of DCE-MRI and APTWI.Mann-Whitney Utest was used to compare the differences of APTWI parameters between benign and malignant breast masses,and receiver operating characteristic curve(ROC)was used to compare the diagnostic performance of the three methods.Results Both DCE-MRI and APTWI can be used to distinguish benign and malignant breast masses.And the sensitivity,specificity and accuracy of DCE-MRI were 100.0%,41.5%and 72.9%,respectively.Taking the MTRasym(3.5 ppm)(2.8%)as the ROC optimal cut-off point of APTWI,the sensitivity,specificity and accuracy were 76.0%,70.8%and 73.6%,respectively.The AUC for all enrolled breast masses assessed by DCE-MRI+APTWI(0.877)was significantly greater than that for the DCE-MRI(0.813,P<0.05)or APTWI(0.796,P<0.05),and the sensitivity,specificity and accuracy were 89.3%,86.1%and 87.9%respectively.The AUC for category 4masses assessed by the DCE-MRI+APTWI was significantly greater than that for those assessed by the DCE-MRI type(0.90 vs 0.55,P<0.05).Conclusion A combination of APTWI and DCE-MRI improves the accuracy of diagnosis of benign and malignant breast masses,especially category 4 masses.
作者
王如华
张焱
程敬亮
靳雅楠
李晓茗
张勇
WANG Ruhua;ZHANG Yan;CHENG Jingliang(Department of Magnetic Resonance Imaging,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,P.R.China)
出处
《临床放射学杂志》
北大核心
2022年第3期454-459,共6页
Journal of Clinical Radiology
关键词
磁共振成像
乳腺肿块
酰胺质子转移加权成像
动态增强扫描
Magnetic resonance imaging
Breast masses
Amide proton transfer weighted imaging
Dynamic contrast-enhanced
