| 旷连勤,张玉龙,程海云,徐琰,陈金华,张伟国,陈蓉.1H-MRS复合胆碱（tCho）积分在乳腺良恶性疾病鉴别诊断中的应用[J].中国医学影像技术,2014,30(10):1500~1504 |
| 1H-MRS复合胆碱（tCho）积分在乳腺良恶性疾病鉴别诊断中的应用 |
| Application of total choline compound integral in diferentiating benign and malignant breast disease |
| 投稿时间：2014-04-09 修订日期：2014-05-27 |
| DOI： |
| 中文关键词: 乳腺疾病 磁共振成像 磁共振波谱 诊断, 鉴别 |
| 英文关键词:Breast diseases Magnetic resonance imaging Magnetic resonance spectroscopy Diagnosis, differential |
| 基金项目:国家自然科学基金（81472482）、重庆市自然科学基金（cstc2013jcyjA10116）。 |
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| 中文摘要: |
| 目的 探讨1H-MRS复合胆碱（tCho）积分在乳腺良恶性疾病鉴别诊断中的应用价值。方法 对305例患者行乳腺MR检查，所有病例均经病理证实。扫描序列包括MR平扫、动态增强与单体素1H-MRS，统计学分析应用t检验及ROC曲线分析，并与病理学结果进行对照。结果 305例乳腺病变患者中，良性病变119例，恶性病变186例。乳腺良性病变tCho积分为13.77±11.28，恶性病变为42.30±32.90。恶性病变的tCho积分显著高于良性病变，二者差异具有统计学意义（P<0.001）。ROC曲线分析显示，tCho积分的最佳阈值为29.95，其诊断乳腺恶性病变的特异度为92.44%（110/119），敏感度为60.22%（112/186）。结论 应用1H-MRS tCho积分半定量法鉴别乳腺良恶性病变是可行的，结合MRI形态学特征和血流动力学改变，有助于提高诊断准确性。 |
| 英文摘要: |
| Objective To explore the value of total choline compound (tCho) integral obtained by 1H-MRS in differentiating benign and malignant breast disease. Methods A total of 305 patients underwent plain scan, dynamic contrast enhanced MRI and 1H-MRS in order. Statistical analysis was performed using t test and receiver operating characteristic (ROC) analysis, and a comparative analysis of MRI, 1H-MRS and pathology results was performed. Results Of the 305 patients, 119 lesions were benign, 186 lesions were malignant. The mean tCho integral was 13.77±11.28 in benign lesions and 42.30±32.90 in malignant lesions. The median tCho integral of malignant lesions was higher than benign lesions (P<0.001). At ROC analysis, the optimal threshold was 29.95 for tCho integral, with 60.22% (112/186)sensitivity and 92.44% (110/119) specificity. Conclusion Differentiation between benign and malignant breast disease with tCho integral semiquantification was applicable. The combination of tCho integral, morphologic and kinetic analysis can improve the accurary of diagnosing breast disease. |
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