目的 探讨多参数磁共振(Magnetic resonance imaging,MRI)与实时组织超声弹性成像(Real time tissue ultrasound elastography,RTE)在乳腺肿瘤中的诊断价值.方法 选取2021年10月一 2023年5月泰安市立医院收治的338例乳腺肿瘤患者为研究对象,其中乳腺恶性肿瘤169例作为恶性组,乳腺良性肿瘤169例作为良性组.所有患者均接受多参数MRI与RTE检查,统计恶性组与良性组、恶性组不同病理特征患者多参数MRI、RTE检查参数,比较多参数MRI检查、RTE检查联合多参数MRI与RTE(联合检查)对乳腺肿瘤的鉴别诊断效能以及与乳腺癌病理特征的关联性.结果 恶性组平均扩散率(Mean diffusivity,MD)、扩散系数(Diffusion coeffi-cient,D)低于良性组,平均扩散峰度值(Average diffusion kurtosis value,MK)、灌注分数(Perfu-sion fraction,f)、容积转运参数(Volume transfer parameters,Ktrans)、速率常数(Rate constant,Kep)、血管外细胞外容积分数(Extracellular volume fraction of blood vessels,Ve)、RTE 评分高于良性组,差异有统计学意义(P＜0.05).联合检查对乳腺癌的诊断敏感度、准确度(97.04％、95.56％)高于多参数MRI(84.02％、89.35％)与RTE(82.25％、88.76％)单独检查,差异有统计学意义(P＜0.05);联合检查特异度(94.08％)与多参数MRI检查(94.67％)、RTE检查(95.27％)比较,差异无统计学意义(P＞0.05).淋巴结转移、Ⅲ～Ⅳ期乳腺癌患者MD、D低于无淋巴结转移、Ⅰ～Ⅱ期患者,MK、f、Ktrans、Kep、Ve、RTE评分高于无淋巴结转移、Ⅰ～Ⅱ期患者,差异有统计学意义(P＜0.05).MD、D与乳腺癌淋巴结转移、疾病分期呈负相关,MK、f、Ktrans、Kep、Ve、RTE与乳腺癌淋巴结转移、疾病分期呈正相关(P＜0.05).结论 多参数MRI与RTE单一检查均可诊断乳腺肿瘤良恶性,但二者联合检查可进一步提升诊断准确性,同时评估疾病病理特征,为疾病干预方案的制定提供参考依据.
Diagnostic value of multi-parameter magnetic resonance imaging(MRI)and real-time tissue ultrasound elastography(RTE)in breast tumors
Objective Exploring the diagnostic value of multiparameter magnetic resonance imaging(MRI)and real-time tissue ultrasonic elastography(RTE)in breast tumors.Methods 338 breast cancer patients inthehospital from October 2021 to May 2023 were selected as the study subjects,including 169 cases of malignant breast tumors as the malignant group and 169 cases of benign breast tumors as the benign group.All patients received MRI and RTE examinations.The parameters of multiparameter MRI and RTE examination of the patients with different pathological characteristics in malignant group,benign group and malignant group were counted,and the differential diagnostic efficacy of multiparameter MRI examination,RTEexamination and multiparameter MRI and RTE(joint examination)for breast tumors and their correlation with the pathological characteristics of breast cancer were compared.Results The mean diffusivity(MD)and diffusion coefficient(D)of the malignant group was lower than those of the be-nign group,and the average diffusion kurtosis value(MK),perfusion fraction(f),volume transfer pa-rameters(Ktrans),rate constant(Kep),extracellular volume fraction of blood vessels(Ve)and RTE were higher than those in benign group,and the difference was statistically significant(P＜0.05).The diag-nostic sensitivity and accuracy(97.04％,95.56％)of combined examination for breast cancer were higher than those of multi-parameter MRI(84.02％,89.35％)and RTE(82.25％,88.76％),and the difference was statistically significant(P＜0.05).There was no significant difference in the specificity of combined examination(94.08％)compared with multi-parameter MRI(94.67％)and RTE(95.27％)(P＞0.05).The MD and D of the patients with lymph node metastasis and stage Ⅲ to Ⅳ were lower than those with-out lymph node metastasis and stage Ⅰ to Ⅱ,and the MK,f,Ktrans,Kep,Ve and RTE were higher than those without lymph node metastasis and stage Ⅰ to Ⅱ,the difference was statistically significant(P＜0.05).MD and D were negatively correlated with lymph node metastasis and disease stage,while MK,f,Ktrans,Kep,Ve and RTE were positively correlated with lymph node metastasis and disease stage(P＜0.05).Conclusion Multi parameter MRI imaging omics and RTE examination can differentiate between benign and malignant breast tumor,and combined diagnosis can further improve diagnostic accuracy.It can also evaluate the pathological characteristics of the disease and provide reference for the development of disease intervention plans.
万方数据
维普
