体素内不相干运动扩散加权成像及扩散张量成像对乳腺非特殊类型浸润性癌的诊断价值  

The value of IVIM-DWI and DTI in the diagnosis of invasive breast carcinoma of no special type

作　　者：司丽芳[1] 刘小娟[1] 杨开颜[1] 王丽[1] 马怡尘 蒋涛[1] SI Lifang;LIU Xiaojuan;YANG Kaiyan;WANG Li;MA Yichen;J IANG Tao(Department of Radiology ,Beijing Chaoyang Hospital,Capital Medical University ,Beijing lO0020,China)

机构地区：[1]首都医科大学附属北京朝阳医院放射科,北京100020

出　　处：《实用放射学杂志》2018年第12期1874-1877,共4页Journal of Practical Radiology

摘　　要：目的探讨体索内不相干运动扩散加权成像(IVIM-DWI)及扩散张量成像(DTI)参数对乳腺非特殊类型浸润性癌(NST)进行定量诊断及鉴别诊断价值。方法回顾性分析在本院行MR检查并经病理证实的乳腺NST和其他良性病变患者6例(63个病变)。MR检查包括动态增强磁共振成像(DCE-MRI)、IVIM—DWI和DTI扫描。采用两独立样本t检验比较乳腺NS。与良性病变的表观扩散系数(ADC)、慢速扩散系数(ADCslow)、快速扩散系数(ADCfast)、灌注分数(f)和最大本征张量(λ1)值;以ADC、ADCslow、f、λ1作为预测变量,分别进行Logistic回归分析,预测最佳回归模型;采用受试者工作特征曲线(ROC曲线)分析ADC、ADCslow、f、λ1,和回归模型鉴别乳腺NST与良性病变的效能。结果乳腺NST和良性病变ADC值分别为(1.49士0.63)×10-3mm2/s和(2.31±O.66)×10-3mm2/s,ADCslow值分别为(1.32±O.49)×10-3mm2/s和(2.24±0.65)×10-3mm2/s,ADCfast值分别为(25.98士21.84)×10-3mm2/s和(18.71±12.26)×10-3mm2/s,f值分别为O.20±0.13和O.33±0.15,入1分别为(4.98土O.47)×10-3mm2/s和(5.59±O.59)××,除ADCfast外(P=O.271),其余参数差异均有统计学意义(P均<0.0001)。回归方程显示ADCslow值是鉴别乳腺NST和良性病变的独立预测因素,回归模型鉴别诊断效能高于其他参数。结论乳腺NST与良性病变的ADC、ADCslow、f、λ1值有显著统计学差异,回归模型具有最高的诊断价值,ADCslow是鉴别乳腺NST与良性病变的首选指标。Objective To evaluate the value of IVIM-DWI and DTI parameters in quantitative analysis and differential diagnosis of invasive breast carcinoma of no special type(NST}.Methods We retrospectively analyzed 60patients (63lesions}who underwent MR examination in our hospital and all lesions were verified by pathologic results.MR protocol included DCE-MRI,IVIM-DWI using 14b values and DTI.The ADC,ADCslow ,ADCfast,f,λ1 of lesions were measured and compared by two independent samples t test between the benign lesions and NST.Logistic regression analysis was made using ADC,ADCslow,f,λ1 as predictors in detecting and differentiating the NST,ROC analysis was performed to compare diagnostic performance based on the area under the curve(AUC).Results The ADC,ADCslow,ADCfast,f and λ1 of NST were (1.49±0.63)X 10-3mm2/s,(1.32±0.49}X10-3mm2/s,(25.98±21.84)X 10-s mm2/s,0.20±0.13and (4.98±0.47)X 10-3mm2/s,these values of benign lesions were (2.31±0.66}X10-3mm2/s,(2.24±0.65}X 10-3mm2/s,(18.71± 12.26}X 10-3mm2/s,0.33±0.15and {5.59±0.59}X 10-3mm2/s.All parameters except ADCfast (P=0.271}had significantly statistical differences (P <0.0001)between NST and benign lesions.The regression model showed that ADCslow was an independent predictor in NST's detection.Conclusion The ADC,ADCslow ,f and λ1 is helpful for differentiation between NST and benign lesions.The regression model is most valuable in NST detection and ADCslow is the preferred index.

关 键 词：乳腺肿瘤 扩散加权成像 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]