MRI分型诊断方案对乳腺良恶性病变诊断价值的回顾性研究

李为民; 刘丽; 赵瑞峰; 仪孝臣

中国临床医学影像杂志 ›› 2014, Vol. 25 ›› Issue (10) : 703-706.

论著

MRI分型诊断方案对乳腺良恶性病变诊断价值的回顾性研究

李为民1，刘丽2，赵瑞峰1，仪孝臣1

作者信息 +

MRI typing from architectural and dynamic features: a retrospective study in the differential diagnosis of breast lesions

LI Wei-min1, LIU Li2, ZHAO Rui-feng1, YI Xiao-chen1

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文章历史 +

摘要

目的：回顾性评估MRI分型诊断方案对乳腺良恶性病变的诊断价值。方法：46例（54处病变）患者于手术活检前完成双乳DCE-MRI检查。由两名有乳腺阅片经验的放射科医生独立阅片。根据病变MRI征象从形态结构（肿块的长径、形态和数量，非肿块的分布形态，边界及邻近结构）和增强特性（强化形式和强化曲线）两大方面进行评分、并分为5种类型。MR 1型为双侧乳腺无异常强化区；MR 2型为存在双侧对称强化区；MR 3型为良性或可疑良性病变；MR 4型为交界性病变；MR 5型为恶性或可疑恶性病变。使用Kappa检验评价两名医生分型结果的一致性。以术后病理诊断为金标准，分析分型方案对良恶性病变的诊断效能。结果：两名医生的分型诊断结果有较好一致性，相关系数κ=0.78（95%可信区间为0.68～0.88）。病理证实良性肿块样病变22处（21处为MR 3型，1处为MR 4型），恶性肿块14处（10处为MR 4型，4处为MR 5型），良性非肿块样病变10处（9处为MR 4型，1处为MR 5型），恶性非肿块8处（5处为MR 4型，3处为MR 5型）。以MR 4及5型作为诊断恶性病变的敏感度为100%，特异度为93.8%（30/32）；以MR 5型作为诊断恶性病变的敏感度为31.8%（7/22），特异度为100%。结论：MRI分型诊断方案诊断乳腺病变可靠，且有助于良恶性病变的鉴别诊断，以MR 4、5型作为乳腺病变恶性诊断较为确实有效。

Abstract

Objective: To retrospectively evaluate the diagnostic ability of MRI typing from architectural and dynamic features in the differential diagnosis of breast lesions. Methods: 46 patients with breast lesions(54 lesions) underwent MRI before biopsy or operation. MRI findings were scored and rated into five types from both architectural features(enhancement diameter, shape and quantity of masses; enhancement distribution; border and surrounding structures) and dynamic features(enhancement pattern and time-signal intensity curve). Pathology results were taken as gold standard to evaluate MR imaging types. Results: Pathology revealed 22 benign masses(21 of type 3 and 1 of type 4), 14 malignant masses(10 of type 4 and 4 of type 5), 10 benign lesion without mass(9 of type 4 and 1 of type 5) and 8 malignant lesion without mass(5 of type 4 and 3 of type 5). When type 4 and 5 were considered malignant, MRI showed a sensitivity of 100% and a specificity of 93.8%(30/32). Only type 5 taken as malignant, the specificity was 100% but with a sensitivity of 31.8%(7/22). Conclusion: In the differential diagnosis of breast lesions in benign and malignant qualities, MR imaging types from architectural and dynamic features are of good diagnostic value and types 4 plus 5 as malignancies are of high diagnostic efficacy.

导出引用

李为民;刘丽;赵瑞峰;仪孝臣. MRI分型诊断方案对乳腺良恶性病变诊断价值的回顾性研究[J]. 中国临床医学影像杂志. 2014, 25(10): 703-706

LI Wei-min;LIU Li;ZHAO Rui-feng;YI Xiao-chen. MRI typing from architectural and dynamic features: a retrospective study in the differential diagnosis of breast lesions[J]. Journal of China Clinic Medical Imaging. 2014, 25(10): 703-706

中图分类号： Ｒ737.9 Ｒ445.2