磁共振扩散加权成像在乳腺良恶性病变中的诊断价值  

Diffusion-weighted MR Imaging of Benign and Malignant Breast Lesions

作　　者：张东坡[1] 李优伟[1] 毛磊[1] 王觉[2] 王丽宁[2] 翟仁友[3] 

机构地区：[1]清华大学附属北京市垂杨柳医院放射科 [2]清华大学附属北京市垂杨柳医院,北京100022 [3]首都医科大学附属北京朝阳医院放射科,北京100020

出　　处：《中国CT和MRI杂志》2015年第5期66-70,共5页Chinese Journal of CT and MRI

摘　　要：目的对比正常乳腺及乳腺良、恶性病变的表观弥散系数(ADC),探讨DWI在乳腺良恶性病变中的诊断价值。方法回顾分析行乳腺MRI检查并经病理证实的177例乳腺病变,比较良、恶性病变及正常乳腺组织ADC值的差异,采用接受者工作特征曲线(ROC)确定良恶性病变的ADC界值;比较ADC值在乳腺良恶性病变定性诊断中的效能。结果 177例乳腺病变中良性112例,恶性65例,正常乳腺177例,其平均ADC值分别为(1.57±0.25)×10-3mm2/s、(1.11±0.32)×10-3mm2/s、(1.72±0.22)×10-3mm2/s,良恶性病变ADC界值为1.23×10-3mm2/s,其敏感性和特异性分别为80.42%和92.13%。;按病变形态分组:肿块性病变1 4 4例,恶性47例,良性97例,平均AD C值分别为(1.06±0.27)×10-3mm2/s、(1.58±0.26)×10-3mm2/s,ADC界值为1.23×10-3mm2/s,其敏感性和特异性分别为85.17%和92.84%。;非肿块性病变33例,恶性18例,良性15例,平均ADC值分别为(1.25±0.40)×10-3mm2/s、(1.50±0.18)×10-3mm2/s,ADC界值为1.36×10-3mm2/s,其敏感性和特异性分别为77.81%和80.35%。结论乳腺恶性病变的ADC值低于良性病变,根据ADC界值可以鉴别良、恶性,对肿块性病变和非肿块性病变应采用不同的ADC界值,DWI在鉴别乳腺良恶性病变与正常乳腺组织时也有一定价值。Objective To determine the diagnostic potential of Diffusion-weighted MR Imaging to differentiate between benign and malignant breast lesions by comparing apparent diffusion coefficient （ADC） among normal breast tissue, benign and malignant breast lesions.Methods Retrospective analysis of 177 pathologically confirmed breast lesions examined using EPI-DWI and compare the mean ADC among normal breast tissue, benign and malignant breast lesions. The cut-off ADC value for malignant lesion was determined using receiver operating characteristic （ROC） curve analysis. The diagnostic accuracy of DWI was compared in breast mass and non-mass lesions. Results Mean ADC values for benign（112/177）, malignant（65/177） breast lesions and normal breast tissue（177） were （1.57±0.25）×10-3mm2/s, （1.11±0.32）×10-3mm2/s and （1.72±0.22）×10-3mm2/s, respectively. With a cut-off value of 1.23×10-3mm2/s for ADC in ROC analysis, 80.42% sensitivity and 92.13% specificity were achieved. Among 177 lesions 144 were mass and 33 were non-mass. The mean ADC of malignant mass lesions [（1.06±0.27）×10-3mm2/s] was statistically lower than that of benign ones [（1.58±0.26）×10-3mm2/s]. The sensitivity and specificity of the ADC with a threshold of [1.23×10-3mm2/s] was 85.17﹪ and 92.84﹪respectively. The mean ADC of malignant non-mass lesions [（1.25±0.40）×10-3mm2/s] was statistically lower than that of benign ones [（1.50±0.18）×10-3mm2/s]. The sensitivity and specificity of the ADC with a threshold of [1.36×10-3mm2/s] was 77.81﹪ and 80.35﹪respectively.Conclusion The ADC is an effective parameter in distinguishing between malignant and benign breast lesions. The cut-off values of ADCs are different between mass and non-mass lesions. DWI of the breast can help differentiate benign and malignant breast lesions from normal breast tissue.

关 键 词：乳腺疾病 磁共振成像 弥散 

分 类 号：R737.9[医药卫生—肿瘤]