摘要
目的探讨弥散加权成像及其表观扩散系数(apparent diffusion coefficient,ADC)值对乳腺良恶性病变的诊断价值。方法回顾性分析2015年3月~2019年3月在我科室行乳腺磁共振弥散加权成像、动态增强扫描(DCE-MRI)检查并经过病理学证实的67例(恶性24例,良性43例)患者的影像资料。测量乳腺病变的ADC值,采用受试者工作特征曲线(ROC曲线)确定ADC值在评价乳腺良恶性病变的诊断阈值,并计算其敏感度及特异度;在动态增强图像上绘制感兴趣区,从而得到病变的时间-信号强度曲线(TIC),比较DCE-MRI图像结合TIC曲线与ADC值对乳腺良恶性病变诊断的敏感度和特异度。结果病理证实:恶性者24例,良性者43例。DCE-MRI对乳腺癌诊断的敏感度为0.796,特异度为0.716。ADC值对乳腺良恶性病变的诊断阈值为1.11×10-3mm2/s,其对乳腺癌诊断的灵敏度和特异度分别为0.787和0.814。DWI结合DCE-MRI对乳腺病变诊断的敏感度和特异度均有所提高,分别为0.891和0.894。DWI与DCE-MRI对乳腺癌诊断的敏感度和特异度均无明显差异(P>0.05)。结论磁共振弥散加权成像及ADC值的定量分析对乳腺良恶性病变的鉴别有重要意义,是乳腺磁共振动态增强扫描的重要补充方法。
Objective To evaluate the potential role of DWI in differentiating malignant from benign lesions.Methods Sixty-seven cases(24 malignant cases and 43 benign cases)who underwent breast unenhanced DWI and dynamic contrast-enhanced subtraction scan,and got the pathological confirmation afterwards during the March 2015 to March 2019 in our department.The imaging data of 67 patients with breast lesions were analyzed retrospectively.All images underwent dynamic enhancement scanning and DWI.The ADC value of each lesions was measured.Receiver operating characteristic curve(ROC curve)was used to find the best classification threshold of benign and malignant breast lesions,and then its sensitivity and specificity was calculated;the sensitivity and specificity obtained by DCE-MRI image and ADC values of benign and malignant breast lesions were compared.Results By pathology confirmation:there were 24 malignant cases and 43 benign cases.The lesions underwent dynamic contrast-enhanced scan,and the sensitivity of time-signal curve was 0.796,the specificity was 0.716.The threshold ADC value was 1.11×10-3 mm2/s,its diagnosis sensitivity and specificity were0.787 and 0.814.With the combination of DWI and DCE-MRI,the diagnosis sensitivity was0.891,and the specificity was 0.894,they were both improved.There was no significant difference between sensitivity and specificity made by them(P>0.05).Conclusion DWI is an important complemented technique to DCE-MRI for differentiating malignant from benign lesions in breast MRI.
作者
张碧珊
付旷
郭丽丽
孔德华
ZHANG Bi-shan;FU Kuang;GUO Li-li;KONG De-hua(Department of Magnetic Resonance Imaging,The Second Affiliated Hospital of Harbin Medical University,Harbin 150081,China)
出处
《哈尔滨医科大学学报》
CAS
2020年第3期298-301,共4页
Journal of Harbin Medical University
关键词
乳腺病变
磁共振成像
动态增强
弥散加权成像
breast lesions
magnetic resonance imaging
dynamic enhancement
diffusion-weighted imaging
