液、实性区表观扩散系数及其比值在乳腺环形强化病变中的应用价值  

Application value of apparent diffusion coefficient and its ratios of fluid and solid areas in breast rim enhancement lesions

作　　者：廖海 赵阳[1] 丁茜琳 邓文娟[1] 朱旭娜[1] 阳君[1] 王琛[1] LIAO Hai;ZHAO Yang;DING Qianlin;DENG Wenjuan;ZHU Xuna;YANG Jun;WANG Chen(Medical Imaging Center fiuangxi Medical University Cancer Hospital,Guangxi530021,China)

机构地区：[1]广西医科大学附属肿瘤医院医学影像中心,广西南宁530021

出　　处：《实用放射学杂志》2021年第8期1281-1285,共5页Journal of Practical Radiology

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2019046);广西影像医学临床医学研究中心建设项目(桂科AD20238096)。

摘　　要：目的评估液、实性区表观扩散系数(ADC)及其比值对乳腺环形强化病变的应用价值。方法回顾分析178例经病理证实的乳腺环形强化病变患者,分为恶性肿瘤组、良性肿瘤组、炎性病变组,分别测量其液性区ADC值(ADCf)、实性区ADC值(ADCs)、ADCf/ADCs及液性区ADC比值(ADCf-ratio)和实性区ADC比值(ADCs-ratio)。采用AJVOVA作组间比较,通过受试者工作特征(ROC)曲线分析其在乳腺环形强化病变中的诊断效能。结果恶性肿瘤组、良性肿瘤组和炎性病变组的各类型ADC值及其比值差异均有统计学意义(P<0.001),其中ADCf、ADCf/ADCs和ADCf-ratio的组间任意两两比较差异均有统计学意义(P<0.05)。鉴别恶性肿瘤与炎性病变时,ADCf-ratio和ADCf的诊断效能较高,其曲线下面积(AUC)分别为0.967(0.922-0.990)和0.942(0.888-0.975);鉴别诊断炎性病变与良性肿瘤时,ADCf-ratio和ADCf的诊断效能亦较高,其AUC分别为0.918(0.839-0.966)和0.893(0.807-0.949)。结论ADCf-ratio和ADCf对乳腺环形强化病变鉴别诊断效能较高(AUO0.893),液、实性区ADC值及其比值联合应用为评估乳腺环形强化病变提供了一种新方法。Objective To assess the application value of apparent diffusion coefficient(ADC)and its ratios of fluid and solid areas in breast rim enhancement lesions.Methods 178 patients with breast rim enhancement lesions confirmed by pathology were analyzed retrospectively,the patients were divided into malignant tumor group,benign tumor group and inflammatory disease group,and the ADC value of fluid areas(ADCf)fthe ADC value of solid areas(ADCs),ADCf/ADCs,the ADC ratio of fluid areas(ADCf-ratio)and the ADC ratio of solid areas(ADCs-ratio)were measured respectively.ANOVA was used for comparison among the groups,and its diagnostic efficacy in breast rim enhancement lesions was analyzed by receiver operating(ROC)curve.Results The differences in ADC values and its ratios among the three groups of the malignant tumor group,benign tumor group and inflammatory disease group were statistically significant(P<0.001),and the differences of pairwise comparisons between ADCf,ADCf/ADCs and ADCf-ratio were statistically significant(P<0.05).For distinguishing malignant tumors from inflammatory diseases,ADCf-ratio and ADCf had higher diagnostic efficiency,and their area under the curve(AUC)were 0.967(0.922-0.990)and 0.942(0.888-0.975)respectively;For distinguishing inflammatory diseases from benign tumors,the diagnostic efficiency of ADCf-ratio and ADCf was also high,and their AUC were 0.918(0.839-0.966)and 0.893(0.807-0.949),respectively.Conclusion ADCf-ratio and ADCf are highly effective in differential diagnosis of breast rim enhancement lesions(AU00.893).The combined application of the ADC value and it*s ratio of fluid and solid areas provides a new method for evaluating breast rim enhancement lesions.

关 键 词：扩散加权成像 磁共振成像 液性区 实性区 乳腺环形强化病变 

分 类 号：R445.2[医药卫生—影像医学与核医学] R655.8[医药卫生—诊断学]