分子影像学杂志2026，Vol.49Issue(5)：617-622,6.DOI:10.12122/j.issn.1674-4500.2026.05.08
磁共振动态对比增强联合DWI可有效评估肿块型浸润性乳腺癌的术前诊断效能及生物学行为
Dynamic contrast-enhanced MRI combined with DWI effectively evaluates the preoperative diagnostic efficacy and biological behavior of mass-type invasive breast cancer
摘要
Abstract
Objective To investigate the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with diffusion-weighted imaging(DWI)in the preoperative diagnosis and prognostic evaluation of mass-type invasive breast cancer,and to perform a comparative analysis with ultrasound.Methods Clinical and imaging data of 138 patients with suspected breast cancer treated at the People's Hospital of Guangxi Zhuang Autonomous Region from January 2022 to December 2024 were retrospectively analyzed.Postoperative pathological findings served as the gold standard.Diagnostic performance indicators(sensitivity,specificity and AUC)were compared between the two modalities.The associations between imaging margin characteristics and pathological indicators,including Ki-67 index and molecular subtypes,were also analyzed.Results Postoperative pathology confirmed 119 malignant and 19 benign lesions.DCE-MRI+DWI achieved an AUC of 0.844(95%CI:0.748-0.941),higher than that of US(0.759,95%CI:0.639-0.880).DCE-MRI+DWI showed a higher sensitivity(81.5%vs 67.2%),whereas ultrasound demonstrated a higher specificity(84.2%vs 73.7%).The two modalities showed high consistency in the assessment of"unclear margin"(Kappa=0.796).The detection rate of spiculated margin was significantly higher with MRI(52.1%)than with ultrasound(24.4%).On MRI,non-specific unclear margins(ill-defined/lobulated)were associated with high Ki-67 index(P=0.048)and high-risk subtypes(TNBC/HER2+)(P=0.008).In contrast,ultrasound-detected angular and spiculated margins showed no significant association with pathological aggressiveness(P>0.05),and even after combining them into a composite indicator,no effective prognostic stratification capability was observed.Conclusion DCE-MRI combined with DWI is superior to ultrasound in diagnostic performance and prediction of tumor biological behavior,whereas ultrasound serves as an effective complement with its high specificity.The two modalities have stratified and complementary value in preoperative assessment.关键词
浸润性乳腺癌/动态对比增强磁共振成像/扩散加权成像/超声/诊断效能/病理指标Key words
invasive breast cancer/dynamic contrast-enhanced magnetic resonance imaging/diffusion-weighted imaging/ultrasound/diagnostic efficacy/pathological indicators引用本文复制引用
谢灵灵,梁秀群,覃海霞,梁惠..磁共振动态对比增强联合DWI可有效评估肿块型浸润性乳腺癌的术前诊断效能及生物学行为[J].分子影像学杂志,2026,49(5):617-622,6.基金项目
广西自然科学基金(2024GXNSFBA010110) （2024GXNSFBA010110）
