ADC全域直方图联合ADC值鉴别乳腺BI-RADS 3-5类肿块良恶性的价值  

The value of ADC global histogram combined with ADC value in the differential diagnosis of BI-RADS 3-5 breast masses

作　　者：陈艳 韩义娜[1] 刘真真[1] 吕以东[1] 赵鑫[1] CHEN Yan;HAN Yi-na;LIU Zhen-zhen;LV Yi-dong;ZHAO Xin(Department of Medical Imaging,The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450051,China)

机构地区：[1]郑州大学第三附属医院,河南郑州450051

出　　处：《中国临床医学影像杂志》2020年第9期624-628,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨MRI表观扩散系数(ADC)全域直方图参数联合ADC值在鉴别乳腺BI-RADS 3-5类肿块良恶性中的价值。方法:回顾性分析我院经MRI诊断为乳腺BI-RADS 3-5类肿块,且取得病理结果的117例患者(126枚肿块)的资料。分别将ADC图导入MaZda软件,勾画整个肿瘤病灶,取得直方图参数,包括均值,方差,偏度,峰度,第1、10、50、90、99百分位数等;并且在MRI后处理平台的ADC图上,分别测量ADC值。比较ADC全域直方图各参数及ADC值在乳腺BI-RADS 3-5类良恶性肿块中的差异,采用ROC曲线分析ADC全域直方图各参数及ADC值鉴别乳腺BI-RADS 3-5类肿块良恶性的效能。结果:ADC全域直方图参数中均值,方差,偏度,第1、10、50、90、99百分位数等参数在两组间差异有统计学意义(P均<0.05),其中第50百分位数具有最高的鉴别诊断价值,AUC为0.920,敏感度和特异度分别为0.852和0.877。ADC值在两组间差异有统计学意义(P<0.05),AUC为0.88,敏感度和特异度分别为0.820和0.877。两种方法联合诊断AUC为0.93,敏感度和特异度分别为0.852和0.931,可以进一步提高鉴别乳腺BI-RADS 3-5类肿块良恶性的特异度。结论:ADC全域直方图、ADC值及两者联合应用在鉴别诊断乳腺BI-RADS 3-5类肿块良恶性中有较大价值,两者联合应用可提高鉴别诊断的特异度。Objective:To investigate the value of MRI apparent diffusion coefficient(ADC)global histogram combined with ADC value in the differential diagnosis of BI-RADS 3-5 breast masses.Methods:The data of 117 patients(126 masses)diagnosed as BI-RADS 3-5 breast masses by MRI were analyzed retrospectively.The ADC map was imported into Mazda software,the whole tumor focus was outlined,and histogram parameters were obtained,including mean,variance,skewness,kurtosis,the 1st,10th,50th,90th,99th percentile,etc.and ADC values were measured on the ADC map by MRI post-processing platform.The difference of ADC histogram parameters and ADC values for BI-RADS 3-5 breast benign and malignant masses were compared.The ROC curve was used to analyze the ADC histogram parameters and ADC values to identify the benign and malignant breast BI-RADS 3-5 masses.Results:The mean,variance,skewness,1st,10th,50th,90th and 99th percentiles of ADC histogram parameters were significantly different between the two groups(P<0.05).The 50th percentile had the highest value of differential diagnosis,AUC was 0.920,sensitivity and specificity were 0.852 and 0.877,respectively.The difference of ADC values between the two groups was statistically significant(P<0.05),AUC was 0.88,sensitivity and specificity were 0.820 and 0.877,respectively.The combined diagnosis of AUC was 0.93,the sensitivity and specificity were 0.852 and 0.931,respectively,which can further improve the specificity of differentiating breast BI-RADS 3-5 breast masses.Conclusion:ADC global histogram,ADC value and their combination are of great value in the differential diagnosis of breast BIRADS 3-5 breast masses,and their combination can improve the specificity of differential diagnosis.

关 键 词：乳腺肿瘤 磁共振成像 

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