乳腺磁共振精简序列对乳腺良恶性疾病的诊断价值

The Value of Reduced Sequence of Breast Magnetic Resonance Imaging in the Diagnosis of Benign and Malignant Breast Diseases

摘要: 目的：分析乳腺磁共振动态增强联合扩散加权成像序列对乳腺良恶性疾病的诊断价值，探究精简乳腺MRI序列的可行性。方法：回顾性收集行常规乳腺MRI扫描，并有病理结果的患者84例，按照两组方案分别阅读图像：方案A：乳腺磁共振动态增强(DCE) + 乳腺磁共振扩散加权成像(DWI)，方案B：常规乳腺MRI方案(T1WI + T2WI + DCE + DWI)，首次阅片采用方案A，经过2个月洗脱期后采用方案B再次对图像进行阅读，对比分析两种方案对乳腺疾病的诊断效能。结果：方案A的灵敏度、特异度、准确度分别为93.3%，84.6%，89.3%；方案B灵敏度、特异度、准确度分别为91.1%、84.6%、88.1%。受试者工作特征(ROC)曲线下面积(AUC)分别为0.890、0.879，两种方案的AUC值差异无统计学意义(P > 0.05)。结论：乳腺磁共振动态增强加扩散加权成像序列拥有同常规序列一致的高灵敏度、特异度与准确度，诊断效率略高于常规方案，但缩短了扫描时间，精简乳腺MRI扫描序列俨然成为可能。

Abstract: Objective: To analyze the diagnostic value of breast dynamic contrast-enhanced and diffusion-weighted imaging sequence in benign and malignant breast diseases, and to explore the feasibility of simplified breast MRI sequence. Methods: 84 patients who underwent routine breast MRI scanning and had pathological results were retrospectively collected. Read the images according to two groups of schemes: scheme A: dynamic contrast-enhanced breast magnetic resonance imaging (DCE) + breast magnetic resonance diffusion-weighted imaging (DWI), scheme B: routine breast MRI (T1WI + T2WI + DCE + DWI). Scheme A was used for the first reading, and scheme B was used to read the images again after 2 months of elution. The diagnostic efficacy of the two schemes in breast diseases was compared and analyzed. Results: The sensitivity, specificity and accuracy of scheme A were 93.3%, 84.6% and 89.3%, respectively, and the sensitivity, specificity and accuracy of scheme B were 91.1%, 84.6% and 88.1%, respectively. The area under the working characteristic (ROC) curve (AUC) was 0.890 and 0.879, respectively. There was no significant difference in AUC between the two schemes. Conclusion: The dynamic contrast-enhanced and diffusion-weighted MRI sequence has the same high sensitivity, specificity and accuracy as the conventional sequence, and the diagnostic effect is slightly higher than that of the conventional sequence, but the scanning time is shortened, so it is possible to simplify the breast MRI sequence.