摘要
目的:评估基于核磁共振成像(MRI)的乳腺检查简化方案(AP)对筛查乳腺癌的应用价值.方法:回顾性收集行乳腺常规MRI检查并有病理结果的186 例患者共193 个病灶.对入选病例使用3 种方案进行阅片,包括标准全方案(FDP)、简化方案AP1(包括DWI、蒙片、第1 期增强及首期增强减影)、简化方案AP2(包括DWI、蒙片、第1、2 期增强及其减影图像).分别比较3 种方案的扫描时间、阅片时间及诊断效能指标.结果:AP1、AP2 方案的扫描及阅片时间均低于FDP方案(P<0.001).AP1、FDP和AP2 的敏感度分别为 80.9%、93.3%和 96.6%.AP1 与FDP(P=0.104)、AP2 与FDP(P=0.305)的敏感度均无统计学差异(P>0.05),而AP1 与AP2 间具有统计学差异(P=0.011).FDP(86.5%)、AP1(92.3%)及AP2(89.4%)的特异度均无统计学差异.FDP、AP1 及AP2均表现出较高的诊断准确性,曲线下面积(AUC)分别为 0.899±0.025、0.866±0.029 及 0.930±0.021,AP1 的AUC低于FDP(P=0.014)及AP2(P=0.002),AP2 与FDP的AUC差异无统计学意义(P=0.116).结论:MRI的AP方案可节省医疗资源并提高工作效率,且AP2 与FDP的诊断效能相当,AP2 简化方案对筛查乳腺癌有较好的临床应用价值.
Abstract
Objective:To evaluate the clinical utility of abbreviated protocols(AP)of magnetic resonance protocols(MRI)in the detection of breast cancer.Methods:A total of 193 lesions were retrospectively collected from 186 cases of breast routine MRI with pathological results.Radiologists reviewed the images with three protocols respectively,including the standard full diagnostic protocol(FDP),Ap1[consisting of diffusion-weighted imaging(DWI),pre-and the first postcontrast acquisition with derived images(postcontrast subtracted images)],and AP2[consisting of DWI,pre-,the first and the second postcontrast acquisition with derived images(subtracted images)].The scanning time,imaging reading time and diagnostic performance indexes of above three protocols were compared respectively.Results:The scanning time and imaging reading time of AP1 and AP2 were shorter than FDP(P<0.001).The sensitivity of the three protocols were AP1(80.9%),FDP(93.3%)and AP2(96.6%)respectively.There was no significant difference in AP1 vs.AP2(P=0.104)and AP2 vs.FDP(P=0.305),but the sensitivity of AP1 vs.AP2(P=0.011)showed a statistically significant difference.No significant difference was observed in the specificity between FDP(86.5%),AP1(92.3%)and AP2(89.4%)(P>0.05).FDP,AP1 and AP2 all showed high diagnostic performance,and the AUC were 0.899±0.025,0.866±0.029 and 0.930±0.021,respectively.The area under curve of AP1 was lower than that of FDP(P=0.014)and AP2(P=0.002),and there was no statistical difference between AP2 and FDP(P=0.116).Conclusion:AP of MRI can save medical resources and improve work efficiency,and the diagnostic efficiency of AP2 is comparable to that of FDP.AP2 has good clinical utility for breast cancer screening.
维普
万方数据