弥散加权成像在鉴别乳腺良恶性病变中的价值

The Value of Diffusion Weighted Imaging in Differentiating the Benign and Malignant Tumors of Breast

目的:探讨弥散加权成像(DWI)在鉴别乳腺良、恶性病变中的价值。方法:选取20例正常乳腺、22例乳腺良性病变和32例乳腺恶性病变患者为研究对象,采用1.5T MRI扫描仪,行常规T1WI、T2WI及脂肪抑制、DWI、动态增强成像及延迟增强扫描。DWI中的b值分别取200、500、800、1000、1200、1500、2000。比较正常乳腺、良性和恶性病变组的的ADC值,并进行统计学分析。结果:(1)乳腺恶性病变在DWI上表现为高信号,良性病变表现为稍高信号;(2)各组所取得的ADC值因b值不同而不同,同一b值,恶性组与良性组、恶性组与正常组的ADC值有统计学差异,但良性与正常组无差异;(3)随着b值从200升到2000,鉴别良、恶性病变的灵敏度和特异性经历了一个从低到高,再从高到低的过程,在1000时最高,分别为91.2%、89.3%,此时的ADC阈值为1.22。结论:DWI结合ADC值测量,对鉴别乳腺良恶性病变具有较高的临床价值。

Objective： To study the value of diffusiorl weighted imaging in differentiating the benign and malignant tumors of breast. Methods： Select 20 normal breast, 22 benign breast lesions and 32 patients with breast malignancy as research objects, using 1.5T MRI scanner, line T1WI, T2WI and fat-suppressed, DWI and dynamic contrast-enhanced imaging and delayed enhancement scan were underwent on them. b values in the DWI were taken 200,500,800,1000, 1200, 1500, 2000. Measuring the ADC value of normal breast, benign and malignant lesions, and statistically analyzed were underwent on each other. Results： （1） Malignant breast lesions have high signal on DWI imaging, and benign lesions showed a slighrly higher signal; （2） In each group, the ADC values changing with different b values, in the condition of same b value, the ADC values of malignant group and benign group, malignant group and normal group have significantly difference, benign group and normal group, have no difference; （3） With b value from 200 rose to 2000, the sensitivity and specificity of ADC values in differentiating the benign and malignant lesions, changing from low to high, and high to low, the highest appearing in 1000, were 91.2%, 89.3%, the ADC threshold value was 1.22. Conclusion： DWI combined with ADC value measurement, have high clinical value in differentiating benign and malignant breast lesions.