不同MRI序列检出聚丙烯酰胺水凝胶注射隆乳患者乳腺病变效能的比较研究

The different MRI sequences to detect breast lesions in polyacrylamide hydrogel injection for augmentation patients:a comparative study

    摘要
  • 摘要:
    目的 探讨不同MRI序列对聚丙烯酰胺水凝胶（PAHG）注射隆乳后乳腺病变的检出效能。
    方法 回顾性分析80例临床怀疑合并乳腺病变的注射隆乳患者的MRI影像资料，扫描序列包括T1加权像、T2加权像、短时间反转恢复（STIR）、弥散加权成像（DWI）、MR水成像（MRH）及肝脏容积超快速（LAVA）三维多期动态增强序列，分析各序列图像中病灶的信号特点、位置、形态、大小和数量，以及时间-信号强度曲线，分别计算不同序列对乳腺病变的总检出率和对乳腺癌的诊断准确率。各序列病灶的总检出率差异采用R×C交叉表卡方检验，组内两两比较采用卡方检验分析。
    结果 160个乳腺中共检出86个病灶，其中乳腺癌病灶30个。T1加权像、T2加权像、STIR、DWI、MRH及LAVA增强序列对乳腺病灶的总检出率分别为32.56%（28/86）、61.11%（53/86）、63.88%（55/86）、41.66%（36/86）、89.53%（77/86）、100%（86/86），其中乳腺癌病灶诊断准确率分别为33.33%（10/30）、66.67%（20/30）、66.67%（20/30）、46.67%（14/30）、100%（30/30）、100%（30/30）。对各序列乳腺病变的总检出率行R×C交叉表卡方检验：χ2=129.428，P < 0.05，差异有统计学意义；对各序列乳腺癌病灶诊断准确率行R×C交叉表卡方检验：χ2=51.843，P < 0.05，差异有统计学意义。对各序列乳腺病变总检出率和乳腺癌病灶诊断准确率行组内两两比较分析，除T1加权像与MRH、T2加权像与STIR对乳腺病变总检出率的差异无统计学意义外（χ2=1.593、0.100，P均>0.05），其他均有统计学意义（χ2=6.729~87.509，P均 < 0.05）；而MRH与T1加权像、MRH与T2加权像、MRH与STIR、T2加权像与STIR，以及DWI与LAVA增强序列对乳腺癌诊断准确率的差异均无统计学意义（χ2=1.111、2.443、2.443、0.000、0.000，P均>0.05），其他序列的差异有统计学意义（χ2=12.000~30.000，P均 < 0.05）。
    结论 DWI和LAVA增强序列对PAHG注射隆乳后乳腺病变的总检出率最高；合理应用MRI序列，有利于提高乳腺癌病灶的诊断准确率。

     

    Abstract:
    Objective To explore the detective values of various MRI sequences in breast polyacrylamide hydrogel(PAHG) injection for augmentation patients.
    Methods A total of 80 patients who have been injected for augmentation and who have suspected breast lesions were subjected to MRI scanning. The MRI scan sequence included T1 weighted imaging(T1WI), T2 weighted imaging(T2WI), short time inversion recovery(STIR), diffusion weighted imaging(DWI) and MR hydrography(MRH), as well as liver acquisition with valume acceleration(LAVA) dynamic contrast-enhanced sequence. The main sequence analysis indicators included the detection rate of breast disease and breast cancer, and to analyze statistically.
    Results A total of 86 lesions were observed in 160 breasts. The breast-lesion detection rates of the T1WI, T2WI, STIR, DWI and MRH, as well as LAVA dynamic contrast-enhanced sequence were 32.56%(28/86), 61.11%(53/86), 63.88%(55/86), 41.66%(36/86), 89.53%(77/86), and 100%(86/86), respectively; the breast-cancer detection rates of these sequences were 33.33%(10/30), 66.67%(20/30), 66.67%(20/30), 46.67%(14/30), 100%(30/30), and 100%(30/30), respectively. Each MRI scanning sequence of breast-lesion detection rate of R×C cross-table analysis, χ2=129.428, P < 0.05; the difference was statistically significant. Each MRI scanning sequence of breast-cancer detection rate of R×C cross-table analysis, χ2=51.843, P < 0.05; the difference was statistically significant. Each MRI scanning sequence detection rate of breast disease and breast cancer in the group were compared pairwise. The detection rates of breast lesions were not statistically significant in T1WI and MRH, T2WI and STIR(χ2=1.593, 0.100, both P>0.05), whereas those in the other scanning sequences were statistically significant(χ2=6.729~87.509, all P < 0.05). The differences in breast-cancer detection rates in MRH and T1WI, MRH and T2WI, MRH and STIR, T2WI and STIR, and DWI and LAVA were not statistically significant(χ2=1.111, 2.443, 2.443, 0.000, 0.000, all P>0.05), whereas those of the other sequences were statistically significant(χ2=12.000~30.000, all P < 0.05).
    Conclusions The total detection rate of breast lesions with PAHG injection for augmentation mammoplasty by DWI and LAVA-enhanced sequence wasthe highest. Rational use of MRI sequence will help improve the lesion detection rate of patients' breast augmentation PAHG injection and has important clinical value.

     

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