ADC值和乳腺MRI征象对TICⅡ型曲线肿块样病变的诊断价值  

Diagnosis value of ADC values combination with MRI signs on breast lump lesions with the type of TICⅡ

作　　者：陈钇地 龙莉玲[1] 彭鹏[1] 张灵[1] 邓可妹 蓝巧清 CHEN Yidi,LONG Liling,PENG Peng,ZHANG Ling, DENG Kemei,LAN Qiaoqing(Department of Radiology,the First Affiliated Hospital of Guangxi Medical University, Nanning 530021,Chin)

机构地区：[1]广西医科大学第一附属医院放射科,广西南宁530021

出　　处：《实用放射学杂志》2018年第3期370-373,377,共5页Journal of Practical Radiology

摘　　要：目的 探讨表观扩散系数（ADC）值和乳腺MRI征象对时间GAAB2信号强度曲线（TIC）Ⅱ型曲线肿块样病变良恶性鉴别的意义。方法 187例乳腺MRI检查表现为TICⅡ型曲线且有病理结果的患者，分析病灶ADC值、早期强化率、病灶长径及有无分叶、毛刺、乳头凹陷、皮肤增厚，记录同侧腋窝淋巴结长径。计量资料用独立样本t检验，计数资料用卡方检验，采用受试者工作特征曲线（ROC曲线）评价上述指标鉴别诊断良恶性病变的效能。结果 TICⅡ型曲线的乳腺病变中，良恶性病变的ADC值分别为（1.418±0.299）×10^-3mm^2/s和（0.860±0.142）×10^-3mm^2/s（P〈0.01），早期强化率为（170.387±74.580）%和（160.778±39.786）%（P=0.258）。ADC值1.017×10^-3mm^2/s作为诊断阈值,敏感性和特异性分别为89.0%、98.0%；毛刺征的敏感性、特异性为88.2%、88.2%；分叶征的敏感性、特异性分别为92.6%、33.3%；患侧乳腺皮肤增厚敏感性和特异性为35.3%、88.2%；乳头凹陷的敏感性、特异性为20.5%、94.1%；同侧腋窝淋巴结长径＞1.0 cm作为诊断阈值，敏感性、特异性分别为47.8%、80.4%；早期强化率无诊断效能（P＞0.05）。结论 ADC值结合MRI征象鉴别诊断TICⅡ型曲线乳腺良恶性病变敏感性和特异性高。Objective To explore the significance of ADC value combined with MRI signs on identifying benign and malignant breast lump lesions with the type of TICⅡ.Methods 187 patients with breast lump lesions of TICⅡ, which were confirmed by surgical pathology,proceeded MRI. The ADC value, early-phase enhancement rate, length of lesions, lobulated appearance and spiculation, inverted nipple, thickening of the skin and the length of ipsilateral axillary lymph nodes were analyzed and recorded. T-tests was used to analyzed the measurement data,X^2 test was used to analysis the attribute data. The ROC curves were used to evaluate the diagnostic efficiency of ADC value and MRI signs.Results The ADC value was （1.418±0.299）×10^-3mm^2/s and （0.860±0.142）×10^-3mm^2/s（P〈0.01） for breast benign and malignant lesions respectively,while the early-phase enhancement rate were （170.387±74.580）% and （160.778±39.786）%（P=0.258） respectively. When ADC values were used for differential diagnosis of breast benign and malignant lesions with a threshold of 1.017×10^-3 mm^2/s, the area under the sensitivity and specificity were 89.0% and 98.0 The sensitivity and specificity of lobulated appearance, spiculation,inverted nipple and thickening of the skin were 92.6% and 33.3%, 88.2% and 88.2%, 20.5% and 94.1%, 35.3% and 88.2%, respectively. When the 1.0 cm was used as the threshold of the length of ipsilateral axillary lymph, its sensitivity and specificity were 47.8% and 80.4%. The ROC curve of early-phase enhancement rate showed no diagnostic capability（P〉0.05）.Conclusion ADC value combined with MRI features are helpful to improve the sensitivity and specificity in breast lesions with the type of TIC Ⅱ.

关 键 词：乳腺肿瘤 动态增强磁共振成像 表观扩散系数 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]