扩散加权成像及动态增强MRI在鉴别诊断乳腺肿瘤中的价值  

The Actions of Diffusion Weighted Imaging(DWI)and Dynamic Contrast Enhanced MRI in Differentiating Breast Tumors

作　　者：罗艺[1] 余建群[1] 陈冬冬[1] 徐忠孜[1] 曾涵江[1] 

机构地区：[1]四川大学华西医院放射科,成都610041

出　　处：《生物医学工程学杂志》2013年第6期1219-1223,共5页Journal of Biomedical Engineering

摘　　要：为探讨扩散加权成像(DWI)及动态增强MRI(DCE-MRI)在鉴别诊断乳腺良恶性肿瘤中的价值。本研究回顾分析2010年1月-2012年2月本院95例经病理证实的乳腺肿瘤MRI扩散加权成像及动态增强资料。比较乳腺良恶性肿瘤的ADC值、动态增强扫描的时间-信号强度曲线(TIC)及其相关参数,统计分析其在鉴别良恶性肿瘤中的灵敏度及特异度。结果发现(1)DWI:恶性肿瘤的平均ADC值较良性肿瘤的低(P<0.05)。将ADC值<1.2×10-3 mm2/s的病例诊断为恶性肿瘤,灵敏度为74.1%,特异度为70.3%。(2)DCE-MRI:恶性肿瘤的早期强化率(EER)明显高于良性(P<0.05),强化达峰时间(Tpeak)及最大强化率(SImax)则低于良性(P<0.05)。TIC类型:恶性肿瘤多表现为Ⅱ、Ⅲ型曲线,良性肿瘤多表现为Ⅰ型曲线(P<0.05)。动态增强鉴别良恶性肿瘤的灵敏度为89.7%,特异度为70.3%。(3)ADC值联合TIC类型诊断良恶性肿瘤,灵敏度为79.3%,特异度为78.4%。乳腺良恶性肿瘤的DWI及DCI-MRI各具特征,对乳腺肿瘤良恶性的鉴别诊断有着重要的临床意义。We studied the actions of diffusion weighted imaging （DWI） and dynamic contrast enhanced （DCE） mag netic resonance imaging （MRI） in differentiating breast tumors. From January 2010 to February 2012, we retrospec- tively analyzed data of 95 cases with breast tumor pathologically confirmed from DWI and DCE-MRI. We compared the ADC value, time-intensity curve （TIC） and DCE-MRI parameters between breast tumors, and calculated the sen- sitivity and specificity for differentiating breast tumors. The results were as follows： （1） On DWI, mean ADC value of malignant tumor was lower than that of benign tumor （P%0.05）. For differentiating breast malignant tumors from benign neoplasm, a cut-off ADC value of 1.2）〈 10 a mm2/s achieved a sensitivity of 74.1% and specificity of 70.3%. （2） On DCE-MRI, early enhancement ratio （EER） value of malignant tumor was higher than that of benign tumor whereas value of time to peak （Tpeak） and maximal enhancement ratio （SImax） were lower than that of be- nign tumor （all P^O. 05）. As for TIC, type II and [[][ were more frequently seen in malignant tumor than in benign tumor whereas type I was more common in benign tumor than in malignant tumor （all P^0.05）. For differentiating breast malignant tumors from benign neoplasm, DCE-MRI obtained a sensitivity of 89.7 % and specificity of 70.3 %. （3） For differentiating breast malignant tumors from benign neoplasm, ADC value together with TIC obtained a sen- sitivity of 79.3 % and specificity of 78.4%. Malignant or benign breast tumors could have their own unique charac- teristics on DWI and DCE-MRI. These characteristics might be helpful for differentiating these tumors.

关 键 词：乳腺肿瘤 磁共振成像 扩散加权成像 动态增强 

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