MRI动态增强曲线、表观扩散系数及瘤周血管分析联合评价乳腺病变的价值  

3 T MRI evaluation of breast lesions using dynamic contrast-enhanced curve, apparent diffusion coefficient and peritumoral vessel analysis

作　　者：江森[1] 洪又佳[2] 李仰康[1] 张凡 JIANG Sen;HONG You-jia;LI Yang-kang;ZHANG Fan(Department of Radiology,Cancer Hospital of ShantouUniversity Medical College,Guangdong 515031,China)

机构地区：[1]汕头大学医学院附属肿瘤医院放射科,广东汕头515031 [2]汕头大学医学院附属肿瘤医院超声科,广东汕头515031 [3]汕头大学医学院附属肿瘤医院肿瘤研究实验室,广东汕头515031

出　　处：《影像诊断与介入放射学》2018年第3期210-214,共5页Diagnostic Imaging & Interventional Radiology

基　　金：汕头市医疗卫生科技计划项目(汕府科[2018]37号)

摘　　要：目的探讨MRI时间-信号强度曲线(TIC)、表观扩散系数(ADC)及邻近血管征(AVS)单独和联合应用评价乳腺的价值。方法回顾性分析2015年3月~2016年12月行3.0 T MRI检查并有明确病理结果的乳腺病变286例,其中乳腺癌186例,乳腺良性病变100例,分析其TIC类型、测量ADC值及判断AVS,分别计算不同方法以及两两、三种方法联合诊断乳腺病变的敏感性、特异性、符合率、阳性预测值、阴性预测值及曲线下面积,评价不同方法与病理结果的一致性。结果 TIC、ADC及AVS征三者联合评价乳腺良恶性病变时诊断价值及效能最高,敏感度94.6%,特异度93%,符合率94.1%,阳性预测值96.2%,阴性预测值90.3%,AUC达0.94,且与病理结果一致性好(Kappa值0.87),优于单独及两两联合诊断。结论 TIC、ADC及AVS三者联合能有效提高乳腺良恶性病变的诊断能力。Objective To evaluate the utility of time-intensity curve（TIC）, apparent diffusion coefficient（ADC） and adjacent vessel sign（AVS） in breast lesions. Methods From March 2015 to December 2016, 286 cases of breast lesions confirmed by histopathology and examined by 3.0 T MRI were enrolled in the study. 186 were confirmed breast cancer and 100 were benign diseases. Separate and conjunctive analysis with TIC, ADC and AVS in diagnosing benign or malignant breast diseases were made, as well as the consistency of these methods with histopathology. Results Combined application of TIC, ADC and AVS is superior to TIC, ADC or AVS in distinguishing benign and malignant breast lesions. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 94.6%, 93%, 94.1%, 96.2%, and 90.3%, respectively with 0.94 area under the curve,and good consistency with histopathology at κ of 0.87. Conclusion Combining TIC, ADC and AVS can improve the capability of diagnosing benign or malignant breast diseases.

关 键 词：乳腺癌 动态增强扫描 扩散加权成像 磁共振成像 

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]