目的 探究数字乳腺三维断层融合摄影技术(DBT)联合MR波谱在乳腺高危病灶诊断中的应用。方法 选取2020年6月—2021年6月来我院进行乳腺钼靶X线摄影并诊断为BI-RADS 4级及以上的100例乳腺高危病灶患者为研究对象,对入选患者行MR波谱及DBT检查,分析MR波谱征象及DBT乳腺病变摄影特征,以病理结果为标准,评价MR波谱与DBT及两者联用对乳腺高危病灶的诊断疗效。结果 DBT敏感度、特异度、阳性预测值、阴性预测值均高于MR波谱;DBT漏诊率、误诊率均低于MR波谱漏诊率、误诊率,2组诊断方法比较(P<0.05)。MR波谱及DBT对≥2 cm恶性病变的病理诊断结果符合率比较,差异均无统计学意义(P＞0.05)。MR波谱及DBT对乳腺良性病变、恶性病变＜2 cm诊断结果符合率比较,DBT对乳腺高危患者的病理诊断结果符合率高于MR波谱(P＜0.05)。结论 乳腺高危病灶诊断中选择DBT可对乳腺高危病灶诊断中做出准确的分析和判断,对乳腺高危病灶诊断更具有应用价值,值得临床采纳。

Objective To explore the application of digital breast tomosynthesis (DBT) combined with MR wave in the diagnosis of high-risk breast lesions. Methods A total of 100 patients with breast high-risk lesions diagnosed as BI-RADS 4 or above by mammography in our hospital from June 2020 to June 2021 were selected as the research objects. The selected patients were examined by MR spectrum and DBT. The signs of MR spectrum and the photographic characteristics of DBT breast lesions were analyzed. Based on the pathological results, the diagnostic efficacy of MR spectrum, DBT and their combination in the diagnosis of breast high-risk lesions was evaluated. Results The sensitivity, specificity, positive predictive value and negative predictive value of DBT were higher than those of MR spectrum; the missed diagnosis rate and misdiagnosis rate of DBT were lower than those of MR spectrum (P<0.05). There was no significant difference in the coincidence rate of MR spectrum and DBT in the pathological diagnosis of malignant lesions ≥ 2 cm (P>0.05). The coincidence rate of MR spectrum and DBT in the diagnosis of benign and malignant breast lesions<2 cm was higher than that of MR spectrum (P<0.05). Conclusions Selecting DBT in the diagnosis of breast high-risk lesions can make accurate analysis and judgment in the diagnosis of breast high-risk lesions. It has higher application value in the diagnosis of breast high-risk lesions and is worthy of clinical adoption.

目的 探讨MRI液体衰减反转恢复序列（FLAIR）高信号血管征（HVS）对大脑中动脉（MCA）供血区域的诊断价值。方法 选择2021年1月—2022年10月期间我院收治的66例MCA急性脑梗死患者,观察HVS检出情况、HVS检出率与血管狭窄之间的关系及HVS对MCA急性脑梗死患者病情程度及预后的诊断价值。结果 66例MCA急性脑梗死患者中,MRI FLAIR序列检查示有HVS（HVS阳性）40例,无HVS（HVS阴性）26例。轻度狭窄、重度狭窄和闭塞分别为26、24、16例,HVS阳性者的狭窄程度较HVS阴性者严重（P<0.05）。HVS对MCA急性脑梗死患者病情程度的诊断价值：HVS阳性者梗死面积为（86.02±10.26）cm²,大于HVS阴性者的（72.36±9.01）cm²。HVS阳性者在入院时的美国国立卫生研究院卒中量表（NIHSS）评分为（12.87±2.36）分,高于HVS阴性者的（10.28±2.07）分（P<0.05）。结论 MRI FLAIR序列示HVS对判断MCA供血区域梗死有一定价值,有助于MCA供血区急性脑梗死的诊断,对临床预后的评估也具有一定意义。