3.0T多模态MRI对三阴性乳腺癌与非三阴性乳腺癌的鉴别诊断价值及影像学特征分析OA
Differential Diagnostic Value and Imaging Feature Analysis of 3.0 T Multi-modal MRI in Triple-Negative Breast Cancer Versus Non-Triple-Negative Breast Cancer
目的 探讨3.0 T 多模态磁共振成像(MRI)对三阴性乳腺癌(TNBC)与非 TNBC 的鉴别诊断价值,并分析其影像学特征.方法 选取 2023 年 1月至 2025 年 6 月在我院就诊的 80 例乳腺癌患者作为研究对象,所有患者均在月经干净后 7～14d接受 3.0 T 多模态 MRI 检查.以免疫组化染色检查结果作为诊断标准,将入选患者分为 TNBC 组(n=32)和非 TNBC 组(n=48).比较两组的影像学特征(肿瘤数目、直径、形状、边缘、T2 瘤内高信号、强化情况、时间信号强度曲线、乳腺实质背景强化)及定量参数表观扩散系数(ADC),并评估3.0 T多模态 MRI对 TNBC的诊断效能.结果 TNBC组的单灶发病、肿瘤直径>2 cm、病灶呈圆形/椭圆形、边缘光滑、存在T2 瘤内高信号、边缘强化、时间信号强度曲线Ⅱ型、乳腺实质背景强化显著的病例占比及 ADC 值均高于非 TNBC 组(P<0.05).3.0 T 多模态 MRI 诊断 TNBC 的准确度为 93.75%、灵敏度为 93.75%、特异度为93.75%、阳性预测值为 90.91%、阴性预测值为 95.74%,与免疫组化染色结果一致性良好(Kappa值=0.870).结论 TNBC 与非TNBC在3.0 T多模态MRI影像学特征及ADC定量参数上存在显著差异;TNBC 多表现为单灶发病、肿瘤直径>2 cm,病灶形态以圆形/椭圆形为主、边缘光滑,常伴 T2 瘤内高信号等特征.3.0 T 多模态 MRI对 TNBC具有较高的诊断效能,且与免疫组化结果一致性良好,可作为临床鉴别TNBC与非TNBC的有效影像学检查手段.
Objective To investigate the value of 3.0 T multimodal magnetic resonance imaging(MRI)in the differential diagnosis of triple-negative breast cancer(TNBC)and non-TNBC,and to analyze their imaging features.Methods A total of 80 patients with breast cancer admitted to our hospital from January 2023 to June 2025 were selected as research subjects.All patients underwent 3.0 T multimodal MRI examination within 7～14 days after menstruation clean-up.Taking the results of immunohistochemical staining as the diagnostic standard,the selected patients were divided into TNBC group(n=32)and non-TNBC group(n=48).The imaging features(tumor number,diameter,shape,margin,intratumoral high signal on T2WI,enhancement pattern,time-signal intensity curve,background parenchymal enhancement)and the quantitative parameter[apparent diffusion coefficient(ADC)]were compared between the two groups,and the diagnostic efficacy of 3.0 T multimodal MRI for TNBC was evaluated.Results The proportions of cases with single lesion,tumor diameter>2 cm,round/oval lesions,smooth margin,intratumoral high signal on T2WI,rim enhancement,type Ⅱ time-intensity curve and marked background parenchymal enhancement,as well as ADC value in the TNBC group were significantly higher than those in the non-TNBC group(P<0.05).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of 3.0 T multimodal MRI in diagnosing TNBC were 93.75%,93.75%,93.75%,90.91%and 95.74%,respectively,showing good agreement with immunohistochemical staining results(Kappa=0.870).Conclusions There are significant differences in 3.0 T multimodal MRI imaging features and ADC quantitative parameter between TNBC and non-TNBC.TNBC is mostly manifested as single lesion,tumor diameter>2 cm,round/oval lesion shape,smooth margin,and often accompanied by intratumoral high signal on T2WI.3.0 T multimodal MRI has high diagnostic efficacy for TNBC and good consistency with immunohistochemical results,which can be used as an effective imaging method for clinical differentiation of TNBC and non-TNBC.
陈海军;刘琦;马壮;李文涛
河南省人民医院 乳腺外科,河南 郑州 450003河南省人民医院 乳腺外科,河南 郑州 450003河南省人民医院 乳腺外科,河南 郑州 450003河南省人民医院 乳腺外科,河南 郑州 450003
医药卫生
三阴性乳腺癌非三阴性乳腺癌3.0T磁共振成像鉴别诊断价值影像学特征
Triple-negative breast cancerNon-triple-negative breast cancer3.0 T magnetic resonance imagingDifferential diag-nostic valueImaging feature
《临床医学工程》 2026 (5)
514-518,5
河南省二〇二二年科技发展计划项目(项目编号:222102310645)
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