DWI联合MRI动态增强特征对乳腺癌的诊断价值

Diagnostic Value of DWI Combined with MRI Dynamic Enhancement Features in Breast Cancer

目的:探究DWI联合MRI动态增强特征对乳腺癌诊断的价值。方法:回顾性分析经手术病理证实的90例乳腺病变患者(共98个病灶)的临床及影像学资料,所有病例术前均行DWI和MRI动态增强检查,观察病灶的形态、强化方式、时间-信号强度曲线(TIC)以及病灶的表面扩散系数(ADC)值。结果:98个乳腺病灶中,良性病变39个,恶性病变59个。强化的方式:19个边缘强化(2个纤维腺瘤、15个乳腺癌、1个炎症、1个囊肿合并感染);5个导管状强化(4个导管癌、1个增生);3个无强化(乳腺囊肿);40个不均匀强化(30个乳腺癌、1个叶状肿瘤、6个纤维腺瘤、2个增生,1个脂肪坏死并纤维化);28个均匀性强化(10个乳腺癌、7个乳腺增生、8个纤维腺瘤、1个叶状肿瘤、2个导管内乳头状瘤);3个网状强化(2个乳腺炎、1个巨乳症)。时间-信号强度曲线(TIC):29个I型流入型,21个II型平台型,48个III型流出型。表面扩散系数(ADC)值:恶性病变的平均ADC值为(1.06±0.19)×10-3mm2/s,良性病变的平均ADC值为(1.60±0.20)×10-3mm2/s,P<0.05,两者之间差异具有统计学意义,正常腺体的平均ADC值为(1.8+0.32)×10-3mm2/s。结论:DWI联合MRI动态增强扫描可对乳腺良恶性病变做出鉴别诊断,对乳腺癌的诊断具有重要的临床价值。

Objective:To explore the value of DWI combined with MRI dynamic enhancement features in the diagnosis of breast cancer.Methods:The clinical and imaging data of 90 patients with breast lesions confirmed by operation and pathology(98 lesions)were retrospectively analyzed.All patients underwent DWI and MRI dynamic enhancement examination before operation to observe the morphology,enhancement mode and time of the lesion.Signal intensity curve(TIC)and surface diffusion coefficient(ADC)values of the lesion.Results:Of the 98 breast lesions,39 were benign lesions and 59 were malignant lesions.Intensive approach:19 marginal enhancement(2 fibroadenomas,15 breasts cancers,1 inflammation,1 cyst combined with infection);5 ductal enhancements(4 ductal carcinomas,1 hyperplasia);3 no Intensive(breast cyst);40 uneven enhancement(30 breasts cancers,1 phyllodes tumor,6 fibroadenomas,2 hyperplasia,1 fat necrosis and fibrosis);28 uniform enhancement 10 breast cancer,7 breast hyperplasia,8 fibroadenomas,1 phyllodes tumor,2 intraductal papillomas;3 reticular enhancements(2 mastitis,1 large breast disease).Time-Signal Strength Curve(TIC):29 Type I inflows,21 Type II platform types,and 48 Type III outflow types.Surface Diffusion Coefficient(ADC)values:The mean ADC value of malignant lesions was(1.06±0.19)×10-3mm2/s,and the mean ADC value of benign lesions was(1.60±0.20)×10-3mm2/s,P<0.05.The difference was statistically significant.The average ADC value of normal glands was(1.8±0.32)×10-3mm2/s.Conclusion:DWI combined with MRI dynamic enhanced scan can differentially diagnose benign and malignant breast lesions and has important clinical value in the diagnosis of breast cancer.