MR扩散加权成像及表观弥散系数值在乳腺病变诊断中的应用

The application of MR diffusion-weighted-imaging and apparent-diffusion-coefficient values in the diagnosis of mammary disease

目的:探讨乳腺MRI扩散加权成像(DWI)、表观弥散系数(ADC)值在良恶性病变鉴别诊断中的应用价值。材料与方法:以41例乳腺占位性病变患者及12例正常志愿者为研究对象,行1.5T MRI平扫、扩散加权成像,将数据传至Siemes工作站处理,软件自动生成DWI图及对应的ADC图,参照平扫图像上病变的位置,标记圆形感兴趣区,测量病变及对侧正常乳腺的ADC值各3次,取平均值。运用SPSS17.0统计软件进行统计学分析。结果:随着b值的升高,乳腺病变ADC值减少。b取值为1000s/mm2时,正常乳腺组织的ADC值为(1.635±0.121)×10-3mm2/s,良性病变组的为(1.485±0.124)×10-3mm2/s,恶性病变组的为(0.961±0.165)×10-3mm2/s,正常乳腺组织、良性实性病灶及恶性病灶病变的ADC值比较,其ADC值各不相同,ADC值变化趋势为恶性病变<良性病变<正常乳腺。将1.21×10-3mm2/s作为良、恶性病变界值,其诊断敏感性为83.7%,特异性为84.3%,准确性为89.2%。结论:乳腺良恶性病变MRI扩散加权成像在不同b值下ADC值不同,当b值取1000s/mm2时,ADC值用于鉴别乳腺良性、恶性病变有重要的临床意义。

Purpose： To investigate the application value of breast MRI diffusion weighted imaging（DWI） and appar- ent diffusion coefficient（ADC） value in the differential diagnosis of benign and malignant lesions. Materials and Methods： The research object of this study collected 41 patients with breast tumor and 12 healthy volunteers. They were detected on 1.5T MRI scan and diffusion weighted sequence, transmit the original data to SIEMES workstation. The software automatically generates the corresponding DWI and ADC map. Reference position on MRI scan images of lesions, mark circular region of interest, measured lesions and contralateral normal breast ADC value 3 times each, averaged that. Using the SPSS17.0 statis- tical software for statistical analysis. Results： The ADC value of the breast lesions is decrease as b value increases. When the b values are 1000S/mm2, the ADC values of normal breast tissue, benign and malignant lesions are （ 1. 635 ±0. 121 ） × 10 -3 mm2/s, （1. 485 ±0. 124） × 10-3mm2/s and （0. 961 ±0. 135） × 10-3mm2/s, respectively. The ADC value of normal breast tissue, benign lesions and malignant lesions are statistically different. Further comparison shows that, ADC value trend for ma- lignant lesions higher than benign lesions, and benign lesions higher than normal breast. The 1.21 × 10-3 mm2/s as diagnos- tic benign and malignant lesions critical ADC value, its diagnostic sensitivity of 83.75%, 84. 30% specificity, accuracy 89. 2%. Conclusion： When b values are different, the ADC values are different of MRI diffusion weight imagingof benign and malignant breast diseases, the differentiation of malignant from benign breast lesions by ADC value is applicable.