本文選題：乳腺疾病　切入點：磁共振成像　出處：《中國醫(yī)學(xué)影像學(xué)雜志》2015年03期 　論文類型：期刊論文

【摘要】：目的建立一種多參數(shù)乳腺MRI檢查與診斷方式,與美國放射學(xué)院乳腺影像報告和數(shù)據(jù)系統(tǒng)(BI-RADS)分類對應(yīng),改進(jìn)乳腺疾病的處理建議。資料與方法回顧分析278例乳腺疾病患者301個經(jīng)病理證實的病灶,使用1 mm×1 mm×1 mm空間分辨率、120 s時間分辨率的動態(tài)增強(qiáng)掃描(DCE)序列和b=1000 s/mm2的擴(kuò)散加權(quán)成像(DWI)序列進(jìn)行掃描,將DCE顯示早期病灶形態(tài)學(xué)惡性征象、時間-信號強(qiáng)度曲線(TIC)II型或III型、小于良惡性表觀擴(kuò)散系數(shù)(ADC)閾值的3個診斷因素各計1分,腫塊和非腫塊樣強(qiáng)化病灶區(qū)別對待,積分≥2分診斷為BIRADS 5類,積分=1分診斷為BI-RADS 4類,積分1分診斷為BI-RADS 3類,其他特異性良性發(fā)現(xiàn)診斷為BI-RADS 2類,DCE和DWI無異常發(fā)現(xiàn)評價為BI-RADS1類,并與病理學(xué)的良性(B)-高危(HR)-惡性(M)病灶分級進(jìn)行對照,評價其對病灶處理的建議。結(jié)果以HR作為惡性時(M+HR),得到的ROC曲線下面積為0.860;以HR作為良性時(B+HR),得到的ROC曲線下面積為0.876,兩者很接近。經(jīng)過ROC曲線優(yōu)化,在病理上將HR作為良性、在MRI上將BI-RADS 5類作為惡性,獲得敏感度為85.3%,特異度為86.8%,準(zhǔn)確度為85.1%,高于其他組合。如果將病理上HR病灶的處理原則定義為局部切除或短期隨訪,則BI-RADS 5類對M+HR病灶(可切除病灶)陽性預(yù)測值為93.2%;BI-RADS 4類病灶對M+HR病灶的陽性預(yù)測值為46.9%,必須活檢以決定局部切除或短期隨訪;BI-RADS 3類及以下對B+HR病灶的陽性預(yù)測值(隨訪觀察)為90.4%。結(jié)論本研究建立了一個簡單的診斷模型,動態(tài)增強(qiáng)顯示的形態(tài)學(xué)特征、動態(tài)時間-信號強(qiáng)度曲線和DWIADC值取相同的權(quán)重進(jìn)行BI-RADS分類,可以很好地預(yù)測乳腺病灶良性、高危和惡性特征,對指導(dǎo)乳腺疾病的處理方式有實用價值。
[Abstract]:Objective to establish a multi-parameter mammary gland MRI examination and diagnosis method, which corresponds to the classification of mammography report and data system (BI-RADS) of the American College of Radiology. Methods the data and methods A retrospective analysis of 301 pathologically proved lesions in 278 patients with breast disease was made. 1 mm 脳 1 mm 脳 1 mm 脳 1 mm spatial resolution dynamic enhanced scanning (DEC) sequence and diffusion weighted imaging (DWI) sequence of 1 mm 脳 1 mm 脳 1 mm 脳 1 mm ~ (-1) mm ~ (2) spatial resolution were used to scan the lesions. The DCE was used to display the malignant early lesions. The time-signal intensity curve was divided into two types: type II or type III. The three diagnostic factors less than the threshold value of the apparent diffusion coefficient of benign and malignant tumors were divided into three groups: 1 score, 1 grade, and 1 score, respectively. The tumor and non-tumor-like enhancement lesions were treated differently. The integral 鈮，

本文編號：1570123