目的:分析3.0T 磁共振动态增强扫描(DCE - MRI)联合磁共振扩散加权成像(DW - MRI)诊断乳腺癌性病变临床价值。方法收集疑似乳腺肿块患者39例,术前行 DCE - MRI、DW - MRI、二者联合检查,经手术病理组织诊断。记录 DCE - MRI、DW - MRI、联合检查诊断良恶性,与病理结果对比;计算前三种诊断与病理诊断良性和恶性符合率;对比 DCE - MRI、DW - MRI 以及联合检查的敏感度、特异度、准确性;进行个例分析。结果联合确诊良性、恶性符合率分别为85.00%、95.00%,明显高于单独应用 DCE - MRI 或 DW - MRI 的良性及恶性符合率( P 均<0.05);联合诊断敏感度、特异度、准确性分别为95.30%、84.56%、90.06%,特异性及准确性高于 DW - MRI 和 DCE - MRI;联合诊断下恶性病变主要表现为病灶强化,边缘毛刺,时间-信号曲线平台型或流出型,DWI 下病灶高信号,ADC 值明显异常。结论 DCE - MRI 联合 DW - MRI 诊断乳腺癌性病变具有高敏感度、特异度和准确性,用于术前检查具有无创性,对治疗具有指导作用,应用前景广阔。
Objective To analyze the clinical significance of 3. 0T dynamic contrast enhanced MRI(DCE - MRI)combined with mag-netic resonance diffusion weighted imaging(DW - MRI)in diagnosis of breast lesions. Methods Thirty - nine patients with suspected breast tumors were examined by preoperative DCE - MRI combined DW - MRI inspection and pathological diagnosis of desected tissues. The records of joint diagnosis of benign and malignant tumors by DCE - MRI and DW - MRI were compared with phathologic diagnosis;and the coincidence rate of 2 kinds of diagnostic methods with pathologic diagnosis for benign or malignant tumor had been calculated;and the sensitivity,specificity and accuracy of DCE - MRI,DW - MRI and joint inspection had been analyzed. Results The results confirmed that the coicidence rates of benign and malignant tumors by joint examination with DCE - MRI and DW - MRI were 85. 00% and 95. 00% respectively,and it was significantly high-er than single application of either DCE - MRI or DW - MRI( P < 0. 05);and the sensitivity,specificity and accuracy of joint diagnosis were 95. 30% ,84. 56% and 90. 06% respectively,they were higher than those of DCE - MRI,and their specificity and accuracy were higher than those of DW - MRI;and the manifestations of malignant lesions in joint diagnosis were enhancement of lesions,burred edge and time - signal curve as platform - type or outflow type,with high signal lesions under DWI,and ADC was significantly abnormal. Conclusion The diagnosis of breast cancer with 3. 0T dynamic contrast enhanced MRI(DCE - MRI)combined magnetic resonance diffusion weighted imaging(DW - MRI)has high degree of sensitivity,specificity and accuracy,and it can be applied for preoperative noninvasive examination,and it has a guiding role for treat-ment with broad prospects for application.