目的:探讨磁共振动态对比增强成像(Dynamic contrast-enhanced MRI,DCE-MRI)、弥散加权成像(Diffusion weighted imaging,DWI)联合检查对三阴型乳腺癌的诊断价值.方法:选取128例我院2020年 7月至2022年7月就诊的乳腺癌患者作为研究对象.以手术或病理活检结果为"金标准",将患者分为三阴型乳腺癌组(52例)和非三阴型乳腺癌组(76例).两组入院后均行DCE-MRI、DWI检查,比较两组DCE-MRI、DWI检查定量参数[容量转移常数(Volume transfer constant,Ktrans)、速率常数(Rate constant,Kep)、血管外细胞外间隙容积比(Volume of extracellular space per unit volume of tissue,Ve)]及表观扩散系数(Apparent diffusion coefficient,ADC).统计比较DCE-MRI、DWI单独、联合检查对三阴型乳腺癌的诊断结果、诊断效能,并分析DCE-MRI、DWI单独、联合检查对乳腺癌分期的评估价值.结果:与非三阴型乳腺癌组比较,三阴型乳腺癌组Kep较高,Ve、ADC较低(P＜0.05);DCE-MRI、DWI联合诊断阳性患者数量高于单一检测;与DCE-MRI、DWI单独诊断相比,二者联合诊断对于三阴型乳腺癌诊断灵敏度、准确度较高,漏诊率较低(P＜0.05);DCE-MRI、DWI联合分期诊断结果与手术或病理活检分期诊断结果一致性Kappa值大于单一方案诊断,具有较高一致性.结论:DCE-MRI、DWI联合检测可提高诊断准确度、灵敏度,降低漏诊率,诊断效能较高.
Effect of DCE-MRI and DWI combined examination on the diagnostic efficiency of triple negative breast cancer
Objective:To evaluate the diagnostic value of Dynamic contrast-enhanced MRI(DCE-MRI)combined with Diffusion weighted imaging(DWI)in triple negative breast cancer.Methods:128 breast cancer patients in our hospital from July 2020 to July 2022 were selected as research objects.With surgical or pathological biopsy results as the"gold standard",the patients were divided into three negative breast cancer group(52 cases)and non-negative breast cancer group(76 cases).DCE-MRI and DWI examinations were performed in both groups after admission,and quantitative parameters[Volume transfer constant(Ktrans),Rate constant(Kep),Volume of extracellular space per unit volume of tissue(Ve)and Apparent diffusion coefficient,ADC)]were compared between the two groups..The diagnostic results and diagnostic efficacy of DCE-MRI,DWI alone and combined examination were statistically compared for triple negative breast cancer,and the evaluation value of DCE-MRI,DWI alone and combined examination for breast cancer staging was analyzed.Results:Compared with the non-triple negative breast cancer group,the Kep of triple negative breast cancer group was higher,the Ve and ADC were lower(P<0.05).The number of positive patients diagnosed by DCE-MRI and DWI was higher than that by single test.Compared with the single diagnosis of DCE-MRI and DWI,the combined diagnosis of DCE-MRI and DWI was more sensitive and accurate,and the missed diagnosis rate was lower(P<0.05).DCE-MRI,DWI combined staging results and surgical or pathological biopsy staging results consistency Kappa value is greater than single protocol diagnosis,with high consistency.Conclusion:The combined detection of DCE-MRI and DWI can improve the diagnostic accuracy and sensitivity,reduce the rate of missed diagnosis,and have high diagnostic efficiency.
Triple negative breast cancerDynamic contrast enhanced magnetic resonance imagingDiffusion weighted imaging
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