【摘要】 目的：探讨合成磁共振成像（syMRI）联合弥散加权成像（DWI）、动态对比增强磁共振成像（DCE-MRI）在鉴别乳腺成像报告和数据系统（BI-RADS）4类肿块良恶性的价值。方法：回顾性分析2022年1月—2024年1月本院80例患者98个BI-RADS 4类肿块病变的syMRI、DWI和DCE-MRI图像，所有患者均经穿刺活检或手术获得病理结果（51个恶性病变，47个良性病变）,测量表观扩散系数（ADC）、弛豫时间值（T₁、T₂）和质子密度值（PD）,采用logistic回归建立弛豫定量模型、基于DE-MRI的BI-RADS模型，基于弛豫定量参数联合ADC以及BI-RADS建立联合诊断模型，受试者工作特性（ROC）曲线下面积（AUC）评估各模型诊断效能。结果：logistic回归显示ΔT₁%（OR=1.512）、T₂（OR=6.907）可构建弛豫定量模型，时间—信号强度曲线类型（TIC）（OR=2.464）可构建BI-RADS模型，ΔT₁%、T₂、ADC、TIC构建联合诊断模型，联合诊断模型诊断AUC为0.874,显著高于弛豫定量模型0.768和BI-RADS模型0.644,差异均具有统计学意义（P<0.05）。结论：syMRI联合DWI定量参数和DCE-MRI可以提高BI-RADS 4类肿块的诊断效能，是区分乳腺BI-RADS 4类结节良、恶性的一种很有前途的诊断方法。更多还原

【Abstract】 Objective: To explore the value of synthetic magnetic resonance imaging（syMRI） combined with diffusion-weighted imaging（DWI） and dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI） in distinguishing benign and malignant breast imaging reports and data systems（BI-RADS） for type 4 of tumors.Methods: A retrospective analysis was conducted on syMRI, DWI, and DCE-MRI images of 98 BI-RADS type 4 mass lesions in 80 patients at our hospital from January 2022 to January 2024. Pathological results were obtained from biopsy or surgery in all patients（51 malignant lesions and 47 benign lesions）. The apparent diffusion coefficient（ADC）, relaxation time values（T₁,T₂）, and proton density values（PD） were measured. Logistic regression was used to establish a relaxation quantitative model and a BI-RADS model based on DE-MRI, a joint diagnostic model was established based on relaxation quantitative parameters combined with ADC and BI-RADS, and the diagnostic performance of each model was evaluated by the area under the receiver operating characteristic（ROC） curve（AUC）.Results: Logistic regression shows Δ T₁%（OR=1.512）, T₂（OR=6.907） can construct a relaxation quantitative model, and the time signal intensity curve type（TIC）（OR=2.464） can construct a BI-RADS model, a joint diagnostic model was constructed using Δ T₁%, T₂, ADC, and TIC, with a diagnostic AUC of 0.874, significantly higher than the relaxation quantitative model of 0.768 and the BI-RADS model of 0.644, and the differences were statistically significant（P<0.05）. Conclusion: syMRI combined with DWI quantitative parameters and DCE-MRI can improve the diagnostic efficacy of BI-RADS type 4 tumors.It is a promising diagnostic method for distinguishing benign and malignant breast BI-RADS type 4 nodules.更多还原