磁共振扩散加权成像在乳腺良恶性病变中的诊断价值

目的探讨磁共振扩散加权成像在乳腺良恶性病变中的诊断价值。方法收集我院2010年2—8月经手术病理证实或穿刺活检证实的50例乳腺癌患者和50例乳腺良性病变患者。DWI扫描b值分别为400、600、8001、000 s/mm2,测量病灶区域的ADC值,并比较各组之间的差异。结果 b值分别为400、6008、001、000时乳腺癌及良性病变的ADC值,恶性组ADC值明显低于良性组（P〈0.05）。四组不同b值的良恶性病变分别做ROC曲线,以b=1 000 s/mm2时,AUC最大,诊断价值最高,以ADC值为1.23×10-3mm2/s作为良恶性病变的诊断阈值,敏感性为90.0%,特异性为89.8%,准确性为89.9%。结论 DWI结合ADC值测量,对乳腺良恶性病变的鉴别诊断具有较高的临床应用价值。

Diagnostic value of diffusion-weighted MR imaging in distinguishing benign from malignant breast lesions

Objective To investigate the value of diffusion-weighted magnetic resonance imaging in distinguishing benign from malignant breast lesions.Methods 50 cases of breast cancer patients and 50 cases of patients with benign breast lesions went to our hospital from February 2010 to August 2010 were collected.All of the lesions were confirmed by operation and pathology.Diffusion weighted imaging were applied with a b value of 400,600,800 and 1000 s/mm2.Apparent diffusion coefficient（ADC） in lesions area was measured and their differences in statistics were calculated.Results The ADC of malignant lesions were lower than benign lesions.There were significant differences among the ADC value when b=400,600,800,1000 s/mm2（P0.05）.ROC analysis of benign and malignant lesions on basis of 4 different groups of b value was performed.AUC was the highest with the b value being 1000s/mm2.The sensitivity,specificity and accuracy of ADC for the diagnosis of malignant lesion were 90.0 %、89.8 % and 89.9 % with an ADC threshold of 1.23×10-3mm2/s between benign and malignant breast lesions.Conclusion Measured by diffusion-weighted imaging and apparent diffusion coefficient（ADC） is applicable for differential diagnosis of distinguish benign and malignant lesions.