MRI动态增强与弥散加权成像联合应用对乳腺良恶性病变的诊断评价  

Clinical value of combined application of dynamic contrast-enhanced magnetic resonance imaging and diffusion weighted imaging in the diagnosis of breast tumor

作　　者：鱼汀 李国华[1] 李俊晨[1] 

机构地区：[1]常熟市中医院影像中心,江苏常熟215500

出　　处：《海南医学》2015年第11期1622-1625,共4页Hainan Medical Journal

基　　金：常熟市科技计划项目(编号:cs201226)

摘　　要：目的探讨联合应用磁共振动态增强及弥散加权成像对临床诊断乳腺良恶性肿瘤的意义。方法对伴有乳腺肿块的80例患者(良性肿瘤40例,恶性肿瘤40例)行磁共振平扫T1W1、T2W1,Flash-3D动态增强扫描,分别对良恶性病变的形态学特征与动态增强表现进行评估,绘制病变的时间-信号强度曲线,判断其敏感性、特异性;后行弥散加权成像,计算弥散加权成像在不同b值时乳腺良性、恶性肿瘤ADC值,利用ROC曲线判定诊断阈值、敏感性、特异性;最后MRI动态增强扫描及弥散加权成像联合对肿瘤良恶性进行判断,与手术病理结果相对照,研究联合应用磁共振动态增强及弥散加权成像对乳腺癌诊断的敏感性和特异性。结果动态增强扫描中,乳腺恶性肿瘤多为Ⅱ、Ⅲ型曲线,乳腺良性肿瘤多为Ⅰ、Ⅱ型曲线,差异有统计学意义(P<0.05),动态增强扫描诊断的敏感性为90.0%、特异性为62.5%;b值800 s/mm2时,磁共振弥散加权成像诊断的敏感性为92.5%、特异性为75.0%;二者联合应用敏感性为95.0%、特异性为90.0%。结论联合应用磁共振动态增强及弥散加权成像可以提高临床对乳腺良恶性肿瘤诊断和鉴别诊断的敏感性和特异性。Objective To discuss the significance of combined application of dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） and diffusion weighted imaging （DWI） in the diagnosis of breast tumor. Methods Eighty patients with breast tumors were enrolled in the study, including 40 patients of benign tumors and 40 patients of malignant tumors. The patients first received T1W1, T2W1 and Flash-3D DCE-MRI. The morphologic characteristics and dynamic contrast-enhanced manifestations were compared between the benign tumors and malig-nant tumors, and the time-signal intensity curve was drawn, with the sensitivity and specificity evaluated. Then DWI was performed. The apparent diffusion coefficient （ADC） values of benign and malignant tumors at different b values of DWI were calculated, and ROC curve was used to determine the diagnostic threshold, sensitivity, specificity. At last, the benign and malignant tumors were examined by combined application of DCE-MRI and DWI, and the results were compared with those of pathological analysis, with the sensitivity and specificity determined. Results For DCE-MRI, malignant breast tumor mainly showedⅡ,Ⅲcurve and benign tumors showedⅠ,Ⅱcurve, with statisti-cally significant difference （P〈0.05）. The sensitivity was 90.0%and the specificity was 62.5%. For DWI, with b value of 800 s/mm2, the sensitivity, specificity was 92.5%, 75.0%. For combined application of DCE-MRI and DWI, there was a sensitivity of 95.0% and a specificity of 90.0%. Couclusion Combined application of DCE-MRI and DWI could increase the sensitivity and specificity in the diagnosis of breast tumor.

关 键 词：弥散加权成像 动态增强MRI 乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]