全容积ADC直方图分析联合ADC值鉴别乳腺单纯型黏液癌与纤维腺瘤  

The value of full volume ADC histogram analysis combined with ADC value in differentiating pure mucinous breast carcinoma and fibroadenoma

作　　者：陈艳 谭红娜 吕以东[1] 韩义娜[1] 刘真真[1] 陆林[3] CHEN Yan;TAN Hong-na;LV Yi-dong;HAN Yi-na;LIU Zhen-zhen;LU Lin(The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Radiology,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学第三附属医院,河南郑州450052 [2]河南省人民医院放射科,河南郑州450003 [3]郑州大学第三附属医院医学影像科,河南郑州450052

出　　处：《中国临床医学影像杂志》2022年第3期172-175,共4页Journal of China Clinic Medical Imaging

基　　金：河南省自然科学基金,面上科学(项目编号:202300410081);河南省重点研发与推广专项(科技攻关)(项目编号:212102310694)。

摘　　要：目的:探讨MRI全容积表观扩散系数(ADC)直方图参数联合ADC值鉴别乳腺单纯型黏液癌(PMBC)与纤维腺瘤(FA)的价值。方法:回顾性分析16例(16枚肿块)PMBC与20例(20枚肿块)FA患者的ADC图资料,均经病理证实。将两组患者ADC图导入Mazda软件并手动勾画全层病变区域,经软件获得9个直方图参数;另外在MRI后处理平台测量病变最大层面ADC值。比较全容积ADC直方图参数及ADC值在PMBC与FA病变中的差异,采用ROC曲线分析全容积直方图参数、ADC值及两者联合对两组病变的诊断效能。结果:全容积ADC直方图参数中方差、偏度系数,峰度系数、ADC_(90%)、ADC_(99%)等在两组病变间差异有统计学意义(P均<0.05),其中ADC_(99%)具有最高的诊断效能,AUC为0.836,敏感度为0.875,特异度为0.800。均值、ADC_(1%)、ADC_(10%)、ADC_(50%)等直方图参数在两组病变间无统计学差异(P均>0.05)。ADC值在两组病变间差异有统计学意义(P<0.05),AUC为0.820,敏感度为1,特异度为0.650。ADC_(99%)与ADC值联合诊断两组疾病时AUC为0.892,敏感度为1,特异度为0.850,可以进一步提高鉴别PMBC与FA的特异度。结论:全容积ADC直方图参数、ADC值为PMBC与FA的鉴别提供了新的量化指标,在两组病变鉴别中具有较大价值,两者联合诊断能提高鉴别两组病变的特异度。Objective:To investigate the value of MRI apparent diffusion coefficient(ADC)full volume histogram analysis combined with ADC value in differentiating pure mucinous breast carcinoma(PMBC)and fibroadenoma(FA).Methods:The data of 16 patients(16 masses)with PMBC and 20 patients(20 masses)with FA by ADC map were analyzed retrospectively.According ADC maps of the two groups were imported into the Mazda software,the whole mass focus was outlined,and 9 histogram parameters were obtained.In addition,the ADC value of the maximum level on the ADC map was measured by the MRI post-processing platform.The difference was compared between full volume ADC histogram parameters and ADC values for the pure mucinous breast carcinoma and the fibroadenoma.The ROC curve was used to analyze the full volume ADC histogram parameters,ADC values and their combination to identify the pure mucinous breast carcinoma and the fibroadenoma.Results:The skewness,variance,90th and 99th percentiles of full volume ADC histogram parameters were significantly different between the two groups(P<0.05).The 99th percentiles had the highest value of differential diagnosis,the AUC was 0.836,sensitivity was 0.875,and specificity was 0.800,respectively.The mean,1st,10th,50th of full volume ADC histogram param-eters showed no statistical difference between the two groups(P>0.05).The difference of ADC values between the two groups was statistically significant(P<0.05),the AUC was 0.820,sensitivity was 1,and specificity was 0.650,respectively.The combined diagnosis of AUC was 0.892,sensitivity was 1,and specificity was 0.850,respectively,which can further improve the specificity of differentiating the pure mucinous breast carcinoma and the fibroadenoma.Conclusion:Full volume ADC histogram parameters,ADC value and their combination are of great value in the differential diagnosis of the pure mucinous breast carcinoma and the fibroadenoma and their combination can improve the specificity.

关 键 词：乳腺肿瘤 纤维腺瘤 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]