磁共振DCE和DWI联合评价中老年乳腺癌的临床意义  

Value of apparent diffusion coefficient and dynamic enhanced MRI in the differential diagnosis of senile breast cancer

作　　者：张丽萍 

机构地区：[1]江苏省盐城市中医院放射科,江苏盐城224002

出　　处：《医学影像学杂志》2016年第9期1629-1633,共5页Journal of Medical Imaging

摘　　要：目的探讨表观弥散系数与动态增强MRI在鉴别诊断中老年乳腺癌中的价值。方法对疑有乳腺病变中老年患者56例进行双侧乳腺MRI平扫、弥散加权成像和动态增强扫描。结果 DCE-MRI形态学诊断乳腺病变的敏感度、特异度和准确性分别为73.68%、93.75%和82.86%,与手术或病理诊断比较Kappa=0.663;TIC类型诊断乳腺病变的敏感度、特异度和准确性分别为89.47%、68.75%和80.00%,与手术或病理诊断比较Kappa=0.597;当b值取1 000s/mm2时,以ADC=1.222×10-3mm2/s作为ADC诊断乳腺病变的阀值,ADC值诊断乳腺病变的敏感度、特异度和准确性分别为94.74%、81.25%和88.57%,与手术或病理诊断比较Kappa=0.773。结论 DCE-MRI形态学和ADC值诊断乳腺病变与手术病理诊断结果高度一致,其中ADC值诊断乳腺病变的价值略高于DCE-MRI形态学。Objective To investigate the value of apparent diffusion coefficient and dynamic enhanced MRI in the differential diagnosis of senile breast cancer. Methods From March 2013 to February 2015, the patients suspected 56 with breast lesions, who needed to be further confirmed, underwent preoperative for bilateral breast MRI scan. Results The DCE-MRI morphologi- cal-the sensitivity of the diagnosis of breast lesions, specific degrees and accuracy were 73.68% , 93.75% and 73.68% respec- tively, compared with surgery or pathologic diagnosis of Kappa -- 0. 663 ; TIC type the sensitivity of the diagnosis of breast le- sions, specific degrees and accuracy were 89.47% , 68.75% and 89.47% respectively, compared with surgery or pathologic di- agnosis of Kappa -- 0.597 ; When b = 1 000 s/ram2, with ADC = 1. 222×10.3 mm2/s as the threshold of ADC in the diagnosis of breast lesions, the sensitivity of the ADC values in the diagnosis of breast lesions, specific degrees and accuracy were 94.74% , 81.25% and 94.74% respectively, compared with surgery or pathologic diagnosis of Kappa -- 0. 773. Conclusion DCE-MRI morphology and ADC in the diagnosis of breast lesions by pathologic diagnosis were highly consistent with the operation, in which the value of ADC in the diagnosis of breast lesions is slightly higher than the DCE-MRI morphology.

关 键 词：乳腺癌 磁共振动态增强扫描 表观弥散系数 时间信号强度曲线 诊断价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]