DCE-MRI和ADC直方图鉴别乳腺良恶性病变的价值分析  

Value of DCE-MRI and ADC histogram in the identification of benign and malignant breast lesions

作　　者：王玮 许林[1] 向明[1] 赵春刚[1] 王晓洪[1] 范开琴 Wang Wei;Xu Lin;Xiang Ming(Department of Radiology,Dazhou Central Hospital Dazhou 635000,Sichuan Province,China)

机构地区：[1]四川省达州市中心医院放射科,四川达州635000

出　　处：《中国CT和MRI杂志》2020年第4期81-84,F0002,共5页Chinese Journal of CT and MRI

摘　　要：目的分析动态增强磁共振成像(DCE-MRI)和表观扩散系数(ADC)直方图用于鉴别乳腺良恶性病变的临床价值。方法回顾性收集2016年6月-2018年8月本院90例(90个病灶)的乳腺病变患者的临床资料,根据术后病理诊断结果分为良性组64例、恶性组26例。取得手术病理结果之前接收规范DCE-MRI、DWI检查,根据软件得出DCE-MRI定量参数,如容量转移常数(Ktrans)、速率常数(Kep)及血管外细胞外间隙容积分数(Ve);重建ADC直方图,获取平均ADC值(ADCmean)、最小ADC值(ADCmin)、最大ADC值(ADCmax)、ADC差值及直方图的偏度、峰度。结果与良性组比较,恶性组腺体Ktrans、Kep值显著高(P<0.05),Ve值未见明显差异(P>0.05)。通过ROC曲线分析,Ktrans、Kep鉴别恶性、良性乳腺病变的敏感度均>80%,Kep的特异度高达93.75%。与良性组比较,恶性组腺体ADCmean、ADCmin、ADCmax均显著低,ADC差值显著高(P<0.05),直方图的偏度、峰度未见明显差异(P>0.05)。通过ROC曲线分析,ADCmean诊断鉴别恶性、良性乳腺病变敏感度、特异度最高,为80.77%和92.19%,其次为ADC差值的敏感度较高和ADCmin的特异度较高。结论DCE-MRI和ADC直方图对鉴别乳腺良恶性病变有较高的临床应用价值。Objective To analyze the clinical value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI) and apparent diffusion coefficient(ADC) histogram in the identification of benign and malignant breast lesions. Methods The clinical data of 90 patients(90 lesions) with breast lesions in the hospital from June 2016 to August 2018 were retrospectively collected. According to the postoperative pathological diagnostic results, they were divided into benign group(64 cases) and malignant group(26 cases). The standardized DCE-MRI and diffusion weighted imaging(DWI) examination were performed before obtaining surgical pathological results. The DCE-MRI quantitative parameters such as volume transfer constant(Ktrans), rate constant(Kep) and the extravascular-extracellular volume fraction(Ve) were obtained according to the software. The ADC histogram was rebuilt. The mean value of ADC(ADCmean), minimum value of ADC(ADCmin), maximum value of ADC(ADCmax), difference value of ADC, skewness and kurtosis of histogram were obtained. Results Compared with the benign group, the values of Ktrans and Kep of the gland in the malignant group were significantly higher(P<0.05). There was no significant difference in the Ve value between the two groups(P>0.05). Through the analysis by ROC curve, the sensitivity for the differentiation of malignant and benign breast lesions by Ktrans and Kep was greater than 80%. The specificity for that by Kep was as high as 93.75%. Compared with the benign group, the ADCmean, ADCmin and ADCmax of the malignant group were significantly lower, the difference value of ADC was significantly higher(P<0.05). There was no significant difference in the skewness and kurtosis of histogram between the two groups(P>0.05). Through the analysis by ROC curve, the sensitivity and specificity for the diagnosis and differentiation of malignant and benign breast lesions by ADCmean were the highest(80.77% and 92.19%), followed by the sensitivity examined by ADC difference and the specificity examined by ADCmin. Conclus

关 键 词：动态增强磁共振成像 表观扩散系数 乳腺病变 良恶性 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R447[医药卫生—诊断学]