磁共振弥散加权成像在乳腺肿块良恶性鉴别中的应用价值  

Application Value of Magnetic Resonance Diffusion Weighted Imaging in Differentiating Benign and Malignant Breast Masses

作　　者：刘永天[1] 周彦汝 张刚[1] LIU Yong-tian;ZHOU Yan-ru;ZHANG Gang(Department of MRI,The First Affiliated Hospital of Henan University of CM,Zhengzhou 450000,Henan Province,China)

机构地区：[1]河南中医药大学第一附属医院磁共振科,河南郑州450000

出　　处：《中国CT和MRI杂志》2023年第6期83-85,共3页Chinese Journal of CT and MRI

基　　金：2021年河南省卫生健康委国家中医临床研究基地科研专项(2021JDZY095)。

摘　　要：目的探讨磁共振弥散加权成像(DWI)信号特征及ADC值在鉴别乳腺良恶性肿块中的应用价值。方法回顾分析91例乳腺肿块病变的MRI资料,包含40例良性肿块病变和51例恶性肿块病变,所有病例均经病理证实。对照研究良恶性组肿块DWI信号、ADC信号特征,以及定量参数ADC值最大值(ADCmax)、最小值(ADCmin)、均值(ADCmean)、差值(ADCdifference)在良恶性组的差异,对有统计学意义的ADC值绘制ROC曲线,找出诊断效能最高的ADC值参数,并确定其鉴别诊断良恶性肿块的阈值、敏感度及特异度。结果1.良性组肿块DWI信号以高信号为主(85%),恶性组肿块DWI信号表现为高信号(72.5%)及环形高信号(27.5%),两组差异有统计学意义(P<0.001)。2.良性组肿块ADC信号以等信号为主(55%),恶性组肿块ADC信号以低信号为主(72%),两组差异有统计学意义(P<0.001)。3.良恶性组ADCmax分别为(1.425±0.292)×10^(-3)mm^(2)/s、(0.945±0.200)×10^(-3)mm^(2)/s,良恶性组ADCmin分别为(1.013±0.238)×10^(-3)mm^(2)/s、(0.590±0.223)×10^(-3)mm^(2)/s,良恶性组A D C m ea n分别为(1.225±0.229)×10^(-3)mm^(2)/s、(0.750±0.180)×10-3m m 2/s,良恶性组ADCdifference分别为(0.412±0.246)×10^(-3)mm^(2)/s、(0.354±0.163)×10^(-3)mm^(2)/s,良恶性组ADCmax、ADCmin、ADCmean差异均有统计学意义(P<0.001),ADCdifference差异无统计学意义(P=0.208)。4.分别对ADCmax、ADCmin、ADCmean绘制ROC曲线,AU C分别为0.919、0.912、0.952。依据最大约登指数,ADCmean阈值为0.976时,敏感度为90%,特异度为90%。结论磁共振弥散加权成像DWI信号、ADC信号特征及定量参数ADCmean对乳腺肿块良恶性鉴别诊断有较高的应用价值。Objective To investigate the application value of magnetic resonance diffusion weighted imaging signal characteristics and ADC value in differential diagnosis of benign and malignant breast masses.Methods MRI data of 91 pathologically confirmed breast mass lesions were retrospectively analyzed,including 40 benign mass lesions and 51 malignant ones.DWI signal,ADC signal characteristics,and the differences of the ADCmax,ADCmin,ADCmean and ADCdifference values between benign and malignant groups were studied.The ROC curve was drawn for ADC values with statistically significant to find out the ADC value with the highest diagnostic efficiency,and determine the threshold,sensitivity and specificity of benign and malignant differential diagnosis.Results 1.In the benign group,the DWI signals were mainly high(85%),while in the malignant group,the DWI signals were high(72.5%)and ring high(27.5%),the difference was statistically significant(P<0.001).2.In the benign group,ADC signals were mainly equal(55%),while in the malignant group,ADC signals were mainly low(72%),and the difference was statistically significant(P<0.001).3.The ADC max,ADC min,ADC mean,and ADC difference in the benign and malignant groups were(1.425±0.292)×10^(-3)mm^(2)/s and(0.945±0.200)×10^(-3)mm^(2)/s、(1.013±0.238)×10^(-3)mm^(2)/s and(0.590±0.223)×10^(-3)mm^(2)/s、(1.225±0.229)×10^(-3)mm^(2)/s and(0.750±0.180)×10^(-3)mm^(2)/s、(0.412±0.246)×110^(-3)mm^(2)/s and(0.354±0.163)×10^(-3)mm^(2)/s,respectively.There were statistically significant differences in ADCmax,ADCmin and ADCmean between the two groups(P<0.001),while there was no statistically significant difference in ADCdifference(P=0.208).4.ROC curves were drawn for ADCmax,ADCmin and ADCmean,and AUC were 0.919,0.912 and 0.952.When the ADCmean threshold was 0.976,the sensitivity,specificity and accuracy were 90%,90%and 79%.Conclusion DWI signal,ADC signal characteristics and quantitative parameter ADCmean of magnetic resonance diffusion weighted imaging have high application value i

关 键 词：磁共振成像 良恶性 乳腺肿块 弥散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]