評估磁共振光譜在乳癌診斷的臨床應用

朱益瑩; 練淑君; 陳孟瑜

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P39 - 51

医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

DOI： 10.29585/YYWYLL

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评估磁共振光谱在乳癌诊断的临床应用

Evaluation of the Clinical Application of Magnetic Resonance Spectroscopy in the Diagnosis of Breast Cancer

朱益莹(Yi-Ying Jhu) ；练淑君(Shu-Chun Lien) ；陈孟瑜(Meng-Yu Chen)

医学与健康期刊； 8 卷 1 期 (2019 / 03 / 01) ， P39 - 51

繁体中文

磁振光谱；动力曲线；特异性； Magnetic resonance spectroscopy ； Kinetic curve ； Specificity

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摘要 │ 参考文献 (14) │ 国际计量

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Objectives. The incidence of breast cancer continues to rise and it continues to be a major threat of women's health. Thus, breast screening is an urgent and important issue. In this study, we used metabolite spectrum signal MRS (magnetic resonance spectroscopy) to screen for suspected breast lesions and assessed whether adding auxiliary MRI in suspected cases of breast cancer could help improve early diagnosis. Methods. A total of 40 cases with suspected lesions≧1cm received breast MRI with CM (Dotarem) at our hospital. Diagnosis was based on dynamic enhanced KC (kinetic curve) following conventional protocol, MRS, and pathological findings. Results. The collected data from these 40 cases were analyzed. A type three KC and a positive MRS were assumed to indicate malignant lesion. Of the 40 cases, 38 were had pathology proved malignancies. There were 23 cases with type three KC (sensitivity 60.5%, specificity 50%) (p=0.769) (Independent chi-square test (X^2) is 0.526). Thirty with positive MRS were found to have malignancies, with a sensitivity and specificity of 78.9% and 50%, respectively (X^2 of 0.913; p=0.034). Overall, the diagnostic benefit of MRS was better than KC, though the correlation between pathology between the two was weak, with results not being significantly different. Using a formula to combine KC and MRS data, we were able to diagnose malignancies with a total specificity of 75%, and increase the specificity of MRI. Conclusion. Regardless, the results reviewed non-significant, possibly because clinical follow-up inspection process during the case collection period was changed and different from the original inspection process originally planned for this study. Therefore, the detection rate of pathology proven malignancies was higher than the specificity. Another problem was most cases were diagnosed patients, resulting in low sensitivity.

参考文献 ( 14 ) 〈TOP〉

Bartella, L,Morris, EA,Dershaw, DD(2006).Proton MR spectroscopy with choline peak as malignancy marker improves positive predictive value for breast cancer diagnosis: preliminary study.Radiology,239,686-692.
Boetes, C,Barentsz, JO,Mus, RD(1994).MR characterization of suspicious breast lesions with a gadolinium-enhanced TurboFLASH subtraction technique.Radiology,193,777-781.
Dhillon, GS,Bell, N,Ginat, DT,Levit, A,Destounis, S,O'Connell, A(2011).Breast MR Imaging: What the Radiologist Needs to Know.J Clin Imaging Sci,1,48.
Dorrius, MD,Pijnappel, RM,van der Weide, Jansen M(2012).The added value of quantitative multivoxel MR spectroscopy in breast magnetic resonance imaging.Eur Radiol,22,915-922.
Jacobs, MA,Barker, PB,Argani, P,Ouwerkerk, R,Bhujwalla, ZM,Bluemke, DA(2005).Combined Dynamic Contrast Enhanced Breast MR and Proton Spectroscopic Imaging: A Feasibility Study.J Magn Reson Imaging,21,23-28.

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