MRI平扫联合DWI对乳腺良恶性病变诊断价值分析

Analysis of Diagnostic Value of MRI Plan Scan Combination DWI in Breast Benign and Malignant Lesions

目的:探讨MRI平扫联合DWI对乳腺良恶性病变的诊断价值。材料与方法:对病理证实的70例患者MRI常规平扫、扩散加权成像(DWI)及表观扩散系数(ADC)值进行回顾性分析,所有病例均采用SET1WI、FSET2WI压脂序列、单次激发自旋平面-回波成像(SE-EPI)序列行DWI扫描,扩散敏感系数(b值)取1000s/mm2。结果:70例病变中,乳腺癌49例,乳腺腺瘤19例,积乳囊肿2例。MRI平扫诊断乳腺良恶性病变的敏感性为61.2%(30/49),特异性为19%(4/21),准确性为48.6%(34/70)。以病变信号对乳腺良恶性诊断检出率比较无统计学意义(P>0.05)。以恶性病变平均ADC值95%可信区间的上界1.203×10-3mm2/s作为诊断良、恶性病变的界值,所得结果与病理结果比较,诊断敏感性为87.8%(43/49),特异性为85.7%(18/21),准确性为87.1%(61/70)。MRI平扫联合弥散加权成像ADC值综合诊断的敏感性为93.8%(46/49),特异性为90.5%(19/21),准确性为92.8%(65/70)。结论:DWI及ADC值是诊断和鉴别诊断乳腺良、恶性病变的有价值方法;MRI平扫结合DWI成像能明显提高乳腺良恶性病变诊断准确性。

Purpose： To study the diagnostic value of MRI plan scan combination DWI in breast benign and malignant lesions. Materials and Methods： In the 70 cases of breast lumps proved by pathology and surgery were retrospectively analyzed. Examined routine MRI scan,diffusion weighted imaging（ DWI） and apparent diffusion coefficient value（ ADC）,preoperatively,all cases using SET1 WI,FSET2WI pressure fat series,single excitation plane- spin echo imaging（ SE- EPI） to DWI scans,spread sensitive coefficient was（ b 1000 s /mm^2）. Results： Among the 70 cases,49 cases was breast cancer,mammary gland adenoma 19 cases,breast cyst 2 cases. The sensitivity of MRI plan scan in diagnosis of benign and malignant breast lesions was 61. 2%（ 30 /49）,specificity was 19%（ 4 /21）,accuracy was 48. 6%（ 34 /70）. To signal for breast benign and malignant diagnosis detection rate is no statistical significance（ P〉0. 05）. With average ADC values of malignant upper bound of the 95% confidence interval 1. 203 × 10^- 3as the boundary value of the diagnosis of benign and malignant lesions,and results compared with the pathological results,diagnostic sensitivity was 87. 8%（ 43 /49）,specificity was 85. 7%（ 18/21）,accuracy was 87.1%（ 61/70）. MRI plan scan combination diffusion weighted imaging ADC values integrated diagnostic sensitivity was 93. 8%（ 46 /49）,specificity was 90. 5%（ 19 /21）,accuracy was 92. 8%（ 65 /70）. Conclusion：DWI and ADC values was diagnosis and differential diagnosis valuable method of benign and malignant breast lesions; MRI plan scan combination DWI imaging can significantly improve diagnostic accuracy of breast benign and malignant lesions.