动态增强MRI早期强化比值联合病灶周围血管管径在鉴别乳腺良恶性病变中的价值

摘要

目的 探讨动态增强MRI(DCE-MRI)早期强化比值联合病灶周围血管管径在乳腺良恶性病变诊断中的价值.方法 选择乳腺疾病患者72例,根据术后病理结果分为恶性组28例和良性组44例.所有患者术前均行DCE-MRI检查,对比两组患者的达峰时间、强化峰值、早期强化率、早期强化比值、病灶周围血管数目及病灶血管管径.采用受试者工作特征(ROC)曲线分析早期强化率、早期强化比值、病灶血管管径、早期强化比值联合病灶血管管径诊断乳腺恶性病变的效能.结果 恶性组患者的强化峰值、早期强化率、早期强化比值、病灶周围血管数目及病灶血管管径均大于良性组,但达峰时间低于良性组(P<0.05).早期强化率、早期强化比值、病灶周围血管管径、早期强化比值联合病灶周围血管管径诊断乳腺恶性病变的ROC曲线下面积分别为0.783、0.855、0.905、0.971.结论 与其他单独指标比较,早期强化比值联合病灶周围血管管径鉴别乳腺病灶良恶性的效能较高.%Objective To investigate the value of early-phase enhancement ratio in dynamic contrast-enhanced MRI ( DCE-MRI) combined with perilesional vascular diameter in the diagnosis of benign and malignant breast lesions. Methods Seventy-two patients with breast diseases were divided into malignant group ( 28 cases ) and benign group ( 44 cases ) according to the postoperative pathological results. All subjects were examined with DCE-MRI before surgery. Time to peak,peak intensity,early-phase enhancement rate,early-phase enhancement ratio,numbers of perilesional vessels,and perilesional vascular diameter were compared between the two groups. The receiver operating characteristic( ROC) curve was used to evaluate the efficiency of early-phase enhancement rate,early-phase enhancement ratio, perilesional vascular diameter,or early-phase enhancement ratio combined with perilesional vascular diameter in the diagnosis of malignant breast lesions. Results The peak intensity,early-phase enhancement rate,early-phase enhancement ratio,numbers of perilesional vessels, and perilesional vascular diameter were greater,while the time to peak was lower in the malignant group compared to those in the benign group(P<0. 05). The areas under ROC for early-phase enhancement rate,early-phase enhancement ratio,perilesional vascular diameter, and early-phase enhancement ratio combined with perilesional vascular diameter in the diagnosis of malignant breast lesions were 0. 783, 0. 855,0. 905 and 0. 971 respectively. Conclusion Compared with other independent diagnostic indexes,early-phase enhancement ratio combined with perilesional vascular diameter has a higher efficacy in differentiating benign and malignant breast lesions.