多模态MR成像在乳腺良恶性病变中的诊断价值及其与乳腺癌预后的相关性分析

Analysis of the Diagnostic Value of Multi-Modal MR Imaging in Benign and Malignant Breast Lesions and Its Correlation with the Prognosis of Breast Cancer

摘要: 目的：探讨多模态磁共振成像(MRI)在乳腺良恶性病变中的诊断价值，并分析其与乳腺癌预后的相关性，旨在提高乳腺癌的早期诊断率及预后评估的准确性。方法：选取2023年9月至2024年1月期间，乳腺外科就诊的疑似乳腺病变患者40例，均行多模态MRI检查，包括常规MRI、动态增强MRI (DCE-MRI)、弥散加权成像(DWI)及磁共振波谱分析(MRS)。记录并分析各模态下的影像特征，结合病理诊断结果，评估多模态MRI对乳腺良恶性病变的诊断效能，并分析ADC值(表观扩散系数)等定量参数与乳腺癌预后的关系。结果：在40例患者中，共检出乳腺病灶45个，经病理证实恶性病灶28个，良性病灶17个。恶性病灶在MRI上主要表现为形态不规则、边界不清、分叶及毛刺征等，而良性病灶多呈圆形或类圆形，边界清晰。多模态MRI对乳腺良恶性病变的诊断敏感性为92.9%，特异性为88.2%。恶性病灶的平均ADC值为(0.75 ± 0.16) mm²/s，显著低于良性病灶的(1.43 ± 0.32) mm²/s (P < 0.05)。结论：多模态MRI在乳腺良恶性病变的诊断中具有较高的敏感性和特异性，能够清晰显示病灶的形态学特征及代谢水平差异。

Abstract: Objective: To explore the diagnostic value of multimodal magnetic resonance imaging (MRI) in benign and malignant breast lesions and analyze its correlation with the prognosis of breast cancer, aiming to improve the early diagnosis rate of breast cancer and the accuracy of prognostic assessment. Methods: Forty patients with suspected breast lesions who visited the breast surgery department from September 2023 to January 2024 were selected and underwent multimodal MRI examinations, including conventional MRI, dynamic contrast-enhanced MRI (DCE-MRI), diffusion-weighted imaging (DWI), and magnetic resonance spectroscopy (MRS). Imaging features under each modality were recorded and analyzed. Combined with pathological diagnosis results, the diagnostic efficacy of multimodal MRI for benign and malignant breast lesions was evaluated, and the relationship between quantitative parameters such as ADC value (apparent diffusion coefficient) and the prognosis of breast cancer was analyzed. Results: A total of 45 breast lesions were detected in 40 patients, with 28 malignant lesions and 17 benign lesions confirmed by pathology. Multimodal MRI showed a diagnostic sensitivity of 92.9% and a specificity of 88.2% for benign and malignant breast lesions. The average ADC value of malignant lesions was (0.75 ± 0.16) mm²/s, significantly lower than that of benign lesions, which was (1.43 ± 0.32) mm²/s (P < 0.05). Conclusion: Multimodal MRI has high sensitivity and specificity in the diagnosis of benign and malignant breast lesions, capable of clearly displaying the morphological features and metabolic level differences of the lesions.