MRI动态增强扫描及扩散加权成像鉴别乳腺良恶性病变的价值  

Diagnostic Value of Dynamic Enhanced Examination and Diffusion Weighted Imaging in Differentiating Benign and Malignant Breast Lesions

作　　者：王珂[1] 任芳[1] 徐俊卿[1] 郝跃文[1] 王虹[1] 

机构地区：[1]第四军医大学西京医院放射科,西安市新城区710032

出　　处：《现代医用影像学》2017年第1期13-17,共5页Modern Medical Imageology

摘　　要：目的:研究MRI动态增强及DWI鉴别乳腺良恶性病变的半定量及定量价值。方法:分析60例经病理证实的乳腺病变患者的MRI动态增强及DWI,研究TIC、早期强化率及ADC值的诊断效能,并联合三种指标制定综合评分系统。结果:恶性病灶TIC多呈流出型,良性多呈流入型,TIC鉴别良恶性病变的敏感度为0.851,特异度为0.766,AUC为0.781。增强第1周期早期强化率(61.5%)的敏感度为0.882,特异度为0.816,AUC为0.802;第2周期早期强化率(92.3%)的敏感度为0.891,特异度为0.924,AUC为0.895。良恶性病灶ADC值有统计学差异,ADC值1.135×10^(-3)mm^2/s为阈值的敏感度为0.852,特异度为0.734,AUC为0.771。良性病灶综合评分明显低于恶性病灶,其评分与病理结果有明显相关性,r值=0.89,P<0.05。结论:增强第2周期早期强化率是鉴别乳腺良恶性病变最有效的指标,联合三种指标综合评分能够明显提高鉴别诊断的准确率。Purpose： To evaluate the semi-quantitative and quantitative value of dynamic enhancement examination and diffusion weighted imaging （DWI） in differentiating benign and malignant breast lesions. Materials and Methods： 60 patients proved by pathology were collected, whose MR dynamic enhancement examination and DWI were analyzed. The diagnostic value of TIC, early enhanced rate and ADC value was studied, and these three indicators were combined to make a comprehensive scoring system. Result： Malignant lesions mainly presented III type curve, and most benign ones presented I type curve. The sensitivity, specificity and AUC of TIC differentiating benign and malignant breast lesions were 0. 851,0. 766 and 0. 781 respectively. The sensitivity, specificity and AUC of early enhanced rate of the first cycle （61.5%） were 0. 882, 0. 816 and 0. 802, and those of the second cycle （92. 3% ） were 0. 891,0. 924 and 0. 895. ADC value demonstrated a significant difference between benign and malignant lesions, and the sensitivity, specificity and AUC of ADC threshold value 1. 135 × 10-3mm2/s were 0. 852, 0. 734 and 0. 771. The comprehensive scores of benign lesions were significantly lower than malignant ones, which were obviously correlated with pathological results. Conclusion： Early enhanced rate of the second cycle was the most effective indicator, while combined TIC, early enhanced rate and ADC value can effectively improve the accuracy of differential diagnosis.

关 键 词：乳腺 良恶性病变 动态增强 扩散加权成像 鉴别诊断 

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]