ADC值与eADC值对乳腺浸润性导管癌与纤维腺瘤的鉴别诊断价值

Differential Diagnosis Value of ADC and eADC Value in Breast Invasive Duct Cancer and Fibroadenoma

目的：探讨表观扩散系数（ADC值）与指数表观扩散系数（eADC值）对乳腺浸润性导管癌（IDC）与纤维腺瘤的鉴别诊断价值。方法对50例乳腺病变患者进行扩散加权成像（DWI）扫描，66个病灶均被病理证实，包括40例IDC及26例纤维腺瘤。测量两组病变病灶的ADC值及eADC值，并采用独立样本t检验比较两组病变ADC值及eADC值。通过ROC曲线（受试者工作特征曲线）曲线下面积（AUC），评价ADC与eADC对IDC与纤维腺瘤诊断能力，并通过约登指数，计算ADC值与eADC值鉴别两者的最佳阈值。结果IDC的ADC值为（0.8±0.24）×10^-3mm^2/s，纤维腺瘤的ADC为（1.4±0.36）×10^-3mm^2/s，两者差异有统计学意义（t=-5.983，P＜0.05）。IDC的eADC值为0.4542±0.13074，纤维腺瘤的eADC值为0.2069±0.07356，两者差异有统计学意义（t=6.193，P＜0.05）。ADC值、eADC值的AUC分别为0.962、0.950。ADC值的阈值为1.1×10^-3mm^2/s，此时敏感性为90%，特异性为92.3%。eADC值的阈值为0.3183，此时敏感性为90%，特异性为100%。结论ADC值与eADC值对鉴别IDC与纤维腺瘤具有很高的灵敏性及特异性，可成为动态增强扫描的重要补充。

Objective To evaluate the differential diagnosis value of ADC （apparent diffusion coefifcients） and eADC （exponent apparent diffusion coefifcients） value in breast invasive duct cancer （IDC） and ifbroadeno-ma. Methods Diffusion weighted imaging （DWI） were applied in 50 patients with breast disease. 66 lesions were conifrmed by pathology including 40 IDC and 26 ifbroadenoma. ADC, eADC value of these lesions were mea-sured. Independent Samples t Test was used to evaluate whether the ADC and eADC values had signiifcant differ-ences between two groups of lesions. By ROC （receiver operating characteristic curve）, AUC （area under curve） was used to evaluate the diagnosis value of ADC and eADC values in IDC and ifbroadenoma. Youden index was calculated to get optimal threshold value of the ADC and eADC value. Results The ADC value of IDC and ifbro-adenoma were （0.8±0.24） ×10^-3mm^2/s, （1.4±0.36） ×10^-3mm^2/s, with a signiifcant difference （t=-5.983, P〈0.05）, the eADC value of IDC and ifbroadenoma were 0.4542±0.13074, 0.2069±0.07356, with a signiifcant difference （t=6.193, P〈0.05）. AUC of IDC and ifbroadenoma were 0.962 and 0.950, respectively. The threshold value of ADC value was 1.1 ×10^-3mm^2/s, with a diagnostic sensitivity of 90%and a speciifcity of 92.3%, the threshold value of eADC value was 0.3183, with a diagnostic sensitivity of 90%and a speciifcity of 100%. Conclusion ADC and eADC values have a high sensitivity and speciifcity in differential diagnosis of IDC and ifbroadenoma and can be an important supplement of the breast dynamic enhanced scan.