摘要
目的：探讨磁共振乳腺成像（MRM）BI-RADS 3-5类肿块性病变的动态增强（DCE）MR征象、弥散加权成像（DWI）及两者联合应用对乳腺良恶性病变的诊断价值。方法：回顾性分析118个初诊为BI-RADS 3-5类肿块性病变的磁共振征象，对病变形态学、血流动力学及ADC值进行统计学分析，并计算敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）及准确性。结果：DCE-MRI征象中，形状不规则或分叶、边缘不规则或毛刺征、环状强化、早期强化率>100%及廓清型曲线提示恶性病变征象；ROC曲线分析ADC最佳诊断阈值为1.25×10-3 mm2/s，且具有高诊断效能（>0.900）；两者联合应用的敏感性、特异性、PPV、NPV及准确性分别为90.4%、91.4%、96.2%、80%及90.7%。结论：DCE-MRI与DWI联合应用对提高BI-RADS 3-5类肿块性病变的诊断特异性及准确性有重要价值。
Abstract
Objective: To evaluate the diagnostic value of conventional MR mammography(MRM) combined with dynamic contrast-enhanced(DCE) MR imaging, and diffusion-weighted MR imaging(DWI) in the diagnosis and differential diagnosis of BI-RADS category 3-5 breast lesions. Methods: In 118 cases diagnosed as BI-RADS category 3-5 mass lesions, tumor morphology, hemodynamics of the masses and apparent diffusion coefficient(ADC) value were analysed retrospectively. Sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and accuracy were calculated. Results: In DCE-MRI, irregular and lobular shape, irregular and speculated margins, rim enhancement, early contrast-enhanced rate more than 100% and washout time-intensity curve(TIC) were the indicators of malignancy. The optimal threshold of 1.25×10-3mm2/s from receiver operating characteristic(ROC) curve, and have better diagnosis values(>0.900). The combined application provide sensitivity, specificity, PPV, NPV and accuracy were 90.4%, 91.4%, 96.2%, 80% and 90.7%. Conclusion: Conventional MRI combined with DCE-MRI and DWI were helpful to improve the diagnostic specificity and accuracy of BI-RADS category 3-5 breast mass lesions.
关键词
乳腺肿瘤 /
乳腺炎 /
磁共振成像
Key words
Breast neoplasms /
Mastitis /
Magnetic resonance imaging
汪 飞;鲍克志;朱 娟;杨 擎.
MRM BI-RADS 3-5类肿块性病变的DCE-MRI及DWI联合应用价值探讨[J]. 中国临床医学影像杂志. 2013, 24(9): 617-621
WANG Fei;BAO Ke-zhi;ZHU Juan;YANG Qing.
Application value of combined dynamic contrast-enhanced MR imaging and diffusion-weighted MR imaging inmagnetic resonance mammography BI-RADS category 3-5 breast mass lesions[J]. Journal of China Clinic Medical Imaging. 2013, 24(9): 617-621
中图分类号：
Ｒ737.9
Ｒ655.8
R445.2
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