钼靶显示微钙化的导管内病变 MRI 表现特征 及良恶性鉴别诊断研究.

MRI Characteristics and Differential Diagnosis of Benign and Malignant Ductal Lesions with Microcalcifications Detected by Mammography.

Objective: To investigate the MRI characteristics of ductal lesions with microcalcifications detected by mammography, and to evaluate the value of MRI in the differential diagnosis of benign and malignant ductal lesions. Methods: The clinical data of 112 patients with pathologically confirmed ductal lesions with microcalcifications detected by mammography in our hospital from January 2022 to June 2024 were retrospectively analyzed. All patients underwent mammography and MRI examinations. MRI morphological features, dynamic enhancement characteristics, diffusion-weighted imaging (DWI) findings, and apparent diffusion coefficient (ADC)values were analyzed and compared with pathological results. The diagnostic performance of various MRI features was analyzed using ROC curves. Results: Among the 112 patients, there were 47 benign lesions and 65 malignant lesions. Malignant lesions were more likely to present with irregular morphology, heterogeneous T2 signal,lobulation, and spiculation (P＜0.05), while benign lesions were more likely to present with round or oval shapes and homogeneous T2 signal (P＜0.05). Malignant lesions predominantly showed fast rise-fast washout (Washout type)enhancement curves (58.5%), while benign lesions predominantly showed persistent rise (Progressive type)enhancement curves (55.3%). The ADC values of malignant lesions(0.92±0.21×10-3mm²/s) were significantly lower than those of benign lesions(1.45±0.28×10-3mm²/s) (P＜0.001). The combined application of morphological features, dynamic enhancement curves, and ADC values had the highest diagnostic performance, with a sensitivity of 92.3%, specificity of 89.4%, and accuracy of 91.1%. Conclusion: Multi-parameter MRI can comprehensively evaluate ductal lesions with microcalcifications detected by mammography. The combined application of morphological features, dynamic enhancement curve types, and ADC values can effectively improve the accuracy of differential diagnosis between benign and malignant lesions, providing important basis for clinical treatment decisions. [ABSTRACT FROM AUTHOR]

目的: 探讨钼靶显示微钙化的导管内病变在磁共振成像 (MRI) 上的表现特征, 并评估 MRI 在鉴别诊断良 恶性导管内病变中的价值。方法: 回顾性分析 2022 年 1 月至 2024 年 6 月我院经病理证实的 112 例钼靶显示 微钙化的导管内病变患者的临床资料。所有患者均行钼靶及 MRI 检查, 分析 MRI 形态学特征、动态增强特征、 弥散加权成像 (DWI) 表现及表观扩散系数 (ADC) 值, 并与病理结果对照, 采用 ROC 曲线分析各 MRI 特征的 诊断效能。结果: 112 例患者中, 良性病变 47 例, 恶性病变 65 例。恶性病变多表现为不规则形态、不均匀 T 2 信 号及分叶状、毛刺征 (P < 0. 05), 良性病变多表现为圆形或椭圆形、均匀 T 2 信号 (P < 0. 05) 。恶性病变多表现为快 速上升 - 快速消退型 (Washout 型) 强化曲线 (58. 5 %), 良性病变多表现为持续上升型 (Progressive 型) 强化曲线 (55. 3 %)。恶性病变 ADC 值 (0. 92 ± 0. 21 × 10 - 3 mm2 / s) 显著低于良性病变 (1. 45 ± 0. 28 × 10 - 3 mm2 / s) (P < 0. 001)。联 合应用形态学特征、动态增强曲线和 ADC 值的诊断效能最高, 敏感度为 92. 3 %, 特异度为 89. 4 %, 准确度为 91. 1 %。结论: MRI 多参数成像技术能够全面评估钼靶显示微钙化的导管内病变, 特别是形态学特征、动态增强 曲线类型和 ADC 值的联合应用, 可有效提高良恶性鉴别诊断的准确性, 为临床治疗决策提供重要依据。 [ABSTRACT FROM AUTHOR]