中南大学学报(医学版)
中南大學學報(醫學版)
중남대학학보(의학판)
JOURNAL OF CENTRAL SOUTH UNIVERSITY (MEDICAL SCIENCES)
2013年
8期
830-837
,共8页
蒋中标%王云华%贺忠%张乐君%郑凯
蔣中標%王雲華%賀忠%張樂君%鄭凱
장중표%왕운화%하충%장악군%정개
乳腺癌%磁共振成像%诊断指标%优化方案
乳腺癌%磁共振成像%診斷指標%優化方案
유선암%자공진성상%진단지표%우화방안
breast cancer%MRI%diagnosis indicator%optimizing program
目的:优选乳腺癌的3.0T MRI诊断指标并探讨其最佳MRI检查方案。方法:收集乳腺癌病例45例,另以乳腺良性肿瘤病人35例作为对照组,对上述二组所有病人行3.0T MRI检查,包括T1加权成像、抑脂的T2加权成像、扩散加权成像、氢质子波谱分析及动态增强序列成像,以手术病理结果作为诊断乳腺疾病的金标准,病理结果的良、恶性作因变量,将MRI的各个诊断指标作为自变量进行Logistic回归分析,建立Logistic模型,优选MRI检查的诊断指标并以此为基础优化乳腺癌的MRI检查方案。结果:经Logistic回归分析,筛选引入方程的指标包括:肿块的边缘、时间-信号强度曲线类型及b=500 s/mm2时病变的表观弥散系数值,回归方程Logit(P)=-21.936+20.478X6+3.267X7+21.488X3。结论:对乳腺癌的诊断价值较高的诊断指标是肿块的边缘情况、时间-信号强度曲线类型及b=500 s/mm2时病变的表观弥散系数值;常规MRI平扫加动态增强扫描与扩散加权成像为较好的检查方案,而1H-MRS只作为诊断困难时的补充检查。
目的:優選乳腺癌的3.0T MRI診斷指標併探討其最佳MRI檢查方案。方法:收集乳腺癌病例45例,另以乳腺良性腫瘤病人35例作為對照組,對上述二組所有病人行3.0T MRI檢查,包括T1加權成像、抑脂的T2加權成像、擴散加權成像、氫質子波譜分析及動態增彊序列成像,以手術病理結果作為診斷乳腺疾病的金標準,病理結果的良、噁性作因變量,將MRI的各箇診斷指標作為自變量進行Logistic迴歸分析,建立Logistic模型,優選MRI檢查的診斷指標併以此為基礎優化乳腺癌的MRI檢查方案。結果:經Logistic迴歸分析,篩選引入方程的指標包括:腫塊的邊緣、時間-信號彊度麯線類型及b=500 s/mm2時病變的錶觀瀰散繫數值,迴歸方程Logit(P)=-21.936+20.478X6+3.267X7+21.488X3。結論:對乳腺癌的診斷價值較高的診斷指標是腫塊的邊緣情況、時間-信號彊度麯線類型及b=500 s/mm2時病變的錶觀瀰散繫數值;常規MRI平掃加動態增彊掃描與擴散加權成像為較好的檢查方案,而1H-MRS隻作為診斷睏難時的補充檢查。
목적:우선유선암적3.0T MRI진단지표병탐토기최가MRI검사방안。방법:수집유선암병례45례,령이유선량성종류병인35례작위대조조,대상술이조소유병인행3.0T MRI검사,포괄T1가권성상、억지적T2가권성상、확산가권성상、경질자파보분석급동태증강서렬성상,이수술병리결과작위진단유선질병적금표준,병리결과적량、악성작인변량,장MRI적각개진단지표작위자변량진행Logistic회귀분석,건립Logistic모형,우선MRI검사적진단지표병이차위기출우화유선암적MRI검사방안。결과:경Logistic회귀분석,사선인입방정적지표포괄:종괴적변연、시간-신호강도곡선류형급b=500 s/mm2시병변적표관미산계수치,회귀방정Logit(P)=-21.936+20.478X6+3.267X7+21.488X3。결론:대유선암적진단개치교고적진단지표시종괴적변연정황、시간-신호강도곡선류형급b=500 s/mm2시병변적표관미산계수치;상규MRI평소가동태증강소묘여확산가권성상위교호적검사방안,이1H-MRS지작위진단곤난시적보충검사。
Objective:To optimize 3.0T MRI diagnosis indicator in breast cancer and to select the best MRI scan program. <br> Methods:Totally 45 patients with breast cancers were collected, and another 35 patients with benign breast tumor served as the control group. All patients underwent 3.0T MRI, including T1-weighted imaging (T1WI), fat suppression of the T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), 1H magnetic resonance spectroscopy (1H-MRS) and dynamic contrast enhanced (DCE) sequence. With operation pathology results as the gold standard in the diagnosis of breast diseases, the pathological results of benign and malignant served as dependent variables, and the diagnostic indicators of MRI were taken as independent variables. We put all the indicators of MRI examination under Logistic regression analysis, established the Logistic model, and optimized the diagnosis indicators of MRI examination to further improve MRI scan of breast cancer. <br> Results:By Logistic regression analysis, some indicators were selected in the equation, including the edge feature of the tumor, the time-signal intensity curve (TIC) type and the apparent diffusion coeffcient (ADC) value when b=500 s/mm2. hTe regression equation was Logit (P)=-21.936+20.478X6+3.267X7+21.488X3. <br> Conclusion:Valuable indicators in the diagnosis of breast cancer are the edge feature of the tumor, the TIC type and the ADC value when b=500 s/mm2. Combining conventional MRI scan, DWI and dynamic enhanced MRI is a better examination program, while MRS is the complementary program when diagnosis is diffcult.