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目的探讨MR动态增强扫描(DCE)、DWI、氢质子磁共振波谱(~1H-MRS)三者联合检查在乳腺肿瘤的临床应用价值。方法回顾性分析54例乳腺肿瘤患者(恶性29例,良性25例)的DCE、DWI和~1H-MRS表现,并与手术后病理结果对比,得出以DCE为主,分别联合DWI ADC(方法 A)、~1H-MRS(方法 B)及三者结合(方法 C)三种方法对乳腺癌诊断的敏感度、特异度、准确率,并分别评价三种方法与病理诊断的一致性。结果所有患者均得到术后病理证实,方法 A诊断乳腺癌的敏感度为84.0%、特异度为72.4%、准确率为77.8%;方法 B诊断乳腺癌的敏感度为75.9%、特异度为84.0%、准确率为79.6%;方法 C诊断乳腺癌的敏感度为89.6%、特异度为88.0%、准确率为88.9%;方法 A、B法、C法与病理诊断的Kappa值分别0.551、0.594、0.777。结论 DCE、DWI和~1H-MRS三者联合诊断乳腺癌的敏感度、特异度、准确率均明显高于DCE联合DWI或~1H-MRS,且与病理诊断的一致性好。
Objective To investigate the clinical value of MR dynamic contrast-enhanced scanning (DCE), DWI and 1H proton magnetic resonance spectroscopy (~ 1H-MRS) in the diagnosis of breast tumors. Methods The clinical manifestations of DCE, DWI and 1H-MRS in 54 cases of breast cancer (29 cases of malignant and 25 cases of benign) were analyzed retrospectively. The results were compared with postoperative pathological results. A), ~ 1H-MRS (Method B) and the combination of the three methods (Method C) for the diagnosis of breast cancer. The sensitivity, specificity and accuracy of the three methods were evaluated. Results All patients were confirmed by pathology. The sensitivity of method A in diagnosing breast cancer was 84.0%, the specificity was 72.4% and the accuracy was 77.8%. The sensitivity of method B in diagnosing breast cancer was 75.9% and the specificity was 84.0 %, And the accuracy rate was 79.6%. The sensitivity, specificity and accuracy of method C in diagnosing breast cancer were 89.6%, 88.0% and 88.9% respectively. The Kappa values of methods A, B, C and pathological diagnosis were 0.551 and 0.594 , 0.777. Conclusions The sensitivity, specificity and accuracy of DCE, DWI and 1H-MRS in the diagnosis of breast cancer are significantly higher than those of DCE combined with DWI or 1H-MRS, and are consistent with the pathological diagnosis.