磁共振动态增强联合多b值扩散加权成像诊断乳腺癌的价值  

Dynamic Contrast-enhanced Magnetic Resonance Imaging Combined with Multi-b Value Diffusion Weighted Imaging in the Diagnosis of Breast Cancer

作　　者：李海英[1] 张义钊 刘鹏[1] 张玫[1] 陈赜[1] 王小琦[1] LI Haiying;ZHANG Yizhao;LIU Peng;ZHANG Mei;CHEN Ze;WANG Xiaoqi(Department of Radiology,Gansu Provincial Cancer Hospital,Lanzhou 730000,China;不详)

机构地区：[1]甘肃省肿瘤医院放射科,甘肃兰州730000 [2]兰州大学第二医院放疗科,甘肃兰州730000

出　　处：《中国医学影像学杂志》2019年第12期901-904,共4页Chinese Journal of Medical Imaging

基　　金：兰州市科技三项经费项目（2017-4-74）

摘　　要：目的探讨MRI动态增强联合1.5T MR多b值扩散加权成像(DWI)诊断乳腺癌的价值。资料与方法选择90例发现有乳腺肿块的女性,经病理诊断良性肿瘤42例,恶性肿瘤48例,术前行MRI动态增强扫描与DWI检查,计算在不同b值时乳腺良性、恶性肿瘤表观扩散系数(ADC)值,并利用受试者工作特征(ROC)曲线判定诊断阈值、敏感度和特异度。结果乳腺良、恶性病变时间-信号强度曲线类型中,良性与恶性病变的Ⅰ、Ⅱ、Ⅲ型比较差异有统计学意义(P<0.05);相同b值时,乳腺良性病变的ADC值均高于恶性病变(P<0.05);当b=800 s/mm^2时,动态增强联合多b值DWI诊断乳腺癌的敏感度为95.83%,特异度为90.48%,准确度为93.33%。结论MRI动态增强扫描与1.5T MR多b值DWI联合诊断乳腺癌,能够有效弥补各自的不足,提高诊断的特异度和敏感度,对提高乳腺癌的早期诊断具有重要意义。Purpose To investigate the value of dynamic contrast-enhanced MRI combined with 1.5T MR multi-b value diffusion weighted imaging(DWI)in diagnosing breast cancer.Materials and Methods Ninety women with breast masses were selected.42 benign tumors and 48 malignant tumors were diagnosed by pathology.Before operation,1.5T superconducting MR scanner was used for dynamic contrast-enhanced MRI and DWI to calculate the apparent diffusion coefficient(ADC)value of benign and malignant breast tumors at different b values.Meanwhile,diagnostic threshold,sensitivity and specificity were determined by ROC curve.Results Among the time-signal intensity curve types of benign and malignant breast lesions,difference regarding comparison of typeⅠ,ⅡandⅢbetween benign and malignant lesions was of statistical significance(P<0.05).When b value was the same,ADC values of benign breast lesions were all higher than that of malignant lesions(P<0.05).When b was 800 s/mm^2,the sensitivity,specificity and accuracy of dynamic enhanced combined multi-b value DWI in diagnosing breast cancer were 95.83%,90.48%and 93.33%,respectively.Conclusion The combination of dynamic contrast-enhanced MRI and 1.5T MR multi-b value DWI in the diagnosis of breast cancer could effectively compensate their shortcomings,improve diagnostic specificity and sensitivity and is of great significance to improve early diagnosis of breast cancer.

关 键 词：乳腺肿瘤 磁共振成像 图像增强 扩散加权成像 

分 类 号：R730.42[医药卫生—肿瘤] R737.9[医药卫生—临床医学]