扩散加权成像与多时相增强MRI对T1期乳腺癌诊断的比较研究  

Comparative study of MR DWI and dynamic contrast enhanced MRI for detection of T1 stage breast cancer

作　　者：何翠菊[1] 罗娅红[1] 于韬[1] 赵英杰[1] 刘凡[1] 满江红[1] 路鹏[1] 

机构地区：[1]辽宁省肿瘤医院放射科,辽宁沈阳110042

出　　处：《中国临床医学影像杂志》2009年第9期685-688,713,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:比较MRI扩散加权成像(DWI)与多时相增强MRI(DCE MRI)对T1期乳腺癌的诊断价值。材料与方法:经手术和病理证实的78例共104处乳腺小病灶(最大径≤2cm),其中乳腺癌79处,良性病灶25处。所有患者均行DCE MRI和DWI,DCE MRI采用乳腺多时相增强(VIBRANT)序列,成像后绘制时间-信号强度曲线(TIC);DWI扩散敏感系数(b值)取800s/mm2,SE-EPI序列,在扩散图像处理后的表观扩散系数(ADC)图上测量ADC值,对两种诊断方法的结果进行分析。结果:DCE MRI对T1期乳腺癌的诊断敏感性为94.9%(75/79),特异性为76%(19/25)。DWI中,采用接收者工作特征曲线(ROC)确定良恶性的诊断阈值为1.11×10-3mm2/s,以此值作为判断界值,ADC值诊断T1期乳腺癌的敏感性为89.9%(71/79),特异性为88%(22/25)。DWI与DCE MRI诊断T1期乳腺癌的敏感性与特异性间无统计学差异。根据ADC值结合形态学特征及TIC对T1期乳腺癌诊断的敏感性为91.1%(72/79),特异性为88%(22/25)。结论:DWI对T1期乳腺癌诊断敏感性较高,ADC值对诊断T1期乳腺癌有价值。Objective： To compare the sensitivity of DWI with dynamic contrast enhanced（DCE） MRI to differentiate small benign breast lesions from T1 stage breast cancers. Materials and Methods： 104 lesions（78 patients） proved by pathology included 79 malignant small lesions （≤2cm） and 25 benign small lesions （≤〈2cm） underwent DWI and DCE MRI. GE 1.5T MR and breast coil were used. DCE MRI was performed by VIBRANT sequence and time-signal intensity curve （TIC） was drawn. DWI was done with single shot SE-EPI sequence, b=800s/mm^2 The apparent diffusion coefficients （ADC） diagnostic threshold between malignant and benign lesions was decided according to receiver operating characteristic curve （ROC）. The sensitivity and specificity of DWI for the detection of T1 stage breast cancers were compared with DCE MRI. Results： Seventy-five cases T1 stage breast cancers and 14 cases benign lesions were diagnosed by DCE MRI, the sensitivity and specificity for DCE MRI were 94.9%（75/79） and 76%（19/25）. The ADC threshold between malignant and benign lesions was 1.11×10^-3mm^2/s according to ROC. The sensitivity and specificity for the threshold were 89.9%（71/79） and 88%（22/25）. There was significant difference between the malignant and the benign lesion（P〈0.05）. The sensitivity of DWI ADC value combined plain morphologic features and TIC curve was 91.1%（72/79） in T1 stage breast cancers, and specificity was 88%（22/25）. Conclusion： DWI has a high sensitivity for the detection of T1 stage breast cancer, the ADC value is important to diagnose T1 breast cancer.

关 键 词：乳腺肿瘤 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]