| 宋美娜,何花,王志军,孙杰,宋江.合成MRI联合弥散加权成像及DISCO增强鉴别BI-RADS 4类肿块良恶性[J].中国医学影像技术,2022,38(5):698~702 |
| 合成MRI联合弥散加权成像及DISCO增强鉴别BI-RADS 4类肿块良恶性 |
| Synthetic MRI combined with diffusion weighted imaging and DISCO enhancement for differentiating benign and malignant of BI-RADS 4 masses |
| 投稿时间：2021-07-27 修订日期：2021-10-26 |
| DOI：10.13929/j.issn.1003-3289.2022.05.014 |
| 中文关键词: 乳腺肿瘤 诊断,鉴别 磁共振成像 乳腺影像报告和数据系统 |
| 英文关键词:breast neoplasms diagnosis, differential magnetic resonance imaging breast imaging reporting and data system |
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| 中文摘要: |
| 目的 观察合成MRI联合弥散加权成像(DWI)及基于笛卡尔采集的K空间共享三维容积快速动态成像(DISCO)增强扫描鉴别乳腺影像报告和数据系统(BI-RADS)4类肿块良、恶性的价值。方法 回顾性分析79例经穿刺活检或手术病理证实的乳腺肿瘤病灶,术前乳腺合成MRI(采用MAGiC技术)、DWI及DISCO增强图像共诊断89个BI-RADS 4类肿块,包括63个恶性病变(恶性组)及26个良性病变(良性组);比较组间MAGiC参数、表观弥散系数(ADC)、DISCO增强扫描病变形态学特征及时间-强度曲线(TIC)的差异。针对组间差异有统计学意义的参数,分别采用logistic回归分析和受试者工作特征(ROC)曲线评价MAGiC、DWI、DISCO增强参数及三者联合鉴别良恶性BI-RADS 4类肿块的效能。结果 组间病变形态、内部强化特征及TIC、ADC、T2及R2值差异均有统计学意义(P均＜0.05),其余参数差异均无统计学意义(P均＞0.05)。经logistic回归分析,基于MAGiC、DWI及增强DISCO建立模型。相关参数中,ADC鉴别BI-RADS 4类肿块的良恶性效能最高,曲线下面积(AUC)为0.845;而MAGIC+ADC+DISCO模型的诊断效能最高,AUC为0.908。结论 合成MRI、DWI及增强DISCO对鉴别BI-RADS 4类肿块良恶性均有一定价值;三者联合诊断效能更佳。 |
| 英文摘要: |
| Objective To observe the differential diagnostic value of synthetic MRI combined with diffusion weighted imaging (DWI) and DISCO enhancement based on differential subsampling with cartesian ordering technology for benign and malignant of breast imaging reporting and data system (BI-RADS) 4 masses.Methods Data of synthetic MRI (based on MAGiC technology), DWI and DISCO enhancement images of 79 breast tumor patients with 89 BI-RADS 4 masses diagnosed with preoperative breast MRI and proved with biopsy or surgical pathology were retrospectively analyzed, including 63 malignant lesions (malignant group) and 26 benign lesions (benign group). Parameters of MAGiC and apparent diffusion coefficient (ADC), morphological features and time-intensity curve (TIC) of lesions in enhanced DISCO images were compared between groups. Logistic regression analysis and receiver operating characteristic (ROC) curve were performed for parameters being significant different between group to evaluate the efficacy of MAGiC, DWI, DISCO enhancement and the combination of the above three for predicting benign and malignant lesions.Results There were statistical differences of lesions' morphology, internal enhancement characteristics, TIC, ADC, T2 and R2 values (all P＜0.05), but not of the other parameters between groups (all P＞0.05). After logistic regression analysis, models based on MAGiC, DWI and DISCO enhancement were established. Among the above parameters, ADC had the highest efficiency for differentiating benign and malignant of BI-RADS 4 masses, with the area under the curve (AUC) of 0.845, while MAGiC+DWI+DISCO model had the highest diagnostic efficiency, with AUC of 0.908.Conclusion Synthetic MRI, DWI and DISCO enhancement all had certain value for differentiating benign and malignant of BI-RADS 4 masses, and the combination of the three had better efficiency. |
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