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DCE-MRI+DWI检查在乳腺癌淋巴结转移诊断中的应用价值

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目的 探究动态增强磁共振成像(DCE-MRI)+弥散加权成像(DWI)检查在乳腺癌淋巴结转移诊断中的应用价值.方法 收集2018年1月至2021年2月我院104例乳腺癌患者的临床资料进行回顾性分析,根据是否发生腋下淋巴结转移将其分为转移组(n=63)和未转移组(n=41).患者均经手术病理检查明确病情,并行B超检查、MRI检查.比较两组患者的B超检查特征;比较两组患者的DCE-MRI+DWI检查特征;统计B超、DCE-MRI+DWI检查对淋巴结转移的诊断结果;以术后病理诊断结果为金标准,比较B超、DCE-MRI+DWI检查对淋巴结转移的诊断效能.结果 B超检查结果显示,转移组的长径、短径长于未转移组,形态异常、淋巴门结构异常或消失、内部回声不均匀占比高于未转移组(P<0.05).DCE-MRI+DWI检查结果显示,转移组的长径、短径长于未转移组,皮质厚度、早期强化率、最大强化率高于未转移组,淋巴门消失、边缘欠光滑、脂肪间隙模糊、强化欠均匀、DWI高信号占比高于未转移组,表观弥散系数(ADC)值低于未转移组(P<0.05).DCE-MRI+DWI检查对淋巴结转移的诊断灵敏度、准确度、阴性预测值高于B超检查,漏诊率低于B超检查(P<0.05).结论 B超检查、MRI检查均可对乳腺癌淋巴结转移程度进行评估,采用DCE-MRI+DWI检查可提高淋巴结转移的诊断价值.
Application value of DCE-MRI + DWI in the diagnosis of lymph node metastasis in breast cancer
Objective To explore the application value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)+ diffusion weighted imaging(DWI)in the diagnosis of lymph node metastasis in breast cancer.Methods The clinical data of 104 patients with breast cancer in our hospital from January 2018 to February 2021 were retrospectively analyzed.According to whether axillary lymph node metastasis occurred,the patients were divided into metastasis group(n=63)and non-metastasis group(n=41).All patients were confirmed by surgical pathological examination,and B-ultrasound and MRI were performed.The characteristics of B-ultrasound examination were compared between the two groups;the DCE-MRI + DWI examination characteristics of the two groups were compared;the diagnostic results of B-ultrasound,DCE-MRI + DWI examination for lymph node metastasis were statistically analyzed;the diagnostic efficacy of B-ultrasound and DCE-MRI + DWI for lymph node metastasis was compared with the postoperative pathological diagnosis as the gold standard.Results The results of B-ultrasound examination showed that the long diameter and short diameter of the metastatic group were longer than those of the non-metastatic group,and the proportion of morphological abnormalities,abnormal or disappeared lymphatic hilum structure,and uneven internal echo were higher than those of the non-metastatic group(P<0.05).The results of DCE-MRI + DWI examination showed that the long diameter and short diameter of the metastatic group were longer than those of the non-metastatic group,the cortical thickness,early enhancement rate and maximum enhancement rate were higher than those of the non-metastatic group,the proportion of hilar disappearance,less smooth edge,blurred fat gap,uneven enhancement,and DWI high signal were higher than those in the non-metastasis group,the apparent diffusion coefficient(ADC)value was lower than that of the non-metastatic group(P<0.05).The sensitivity,accuracy and negative predictive value of DCE-MRI + DWI in the diagnosis of lymph node metastasis were higher than those of B-ultrasound,and the rate of missed diagnosis was lower than that of B-ultrasound(P<0.05).Conclusion B-ultrasound examination and MRI examination can evaluate the degree of lymph node metastasis of breast cancer.DCE-MRI + DWI examination can improve the diagnostic value of lymph node metastasis.

dynamic contrast-enhanced magnetic resonance imagingdiffusion weighted imagingbreast cancerlymph node metastasis

蒋志国

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许昌市立医院放射科,河南 许昌,461000

动态增强磁共振成像 弥散加权成像 乳腺癌 淋巴结转移

2024

临床医学研究与实践

临床医学研究与实践

ISSN:
年,卷(期):2024.9(7)
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