乳腺良性病变扩散加权成像与病理相关性研究

The correlative study of diffusion-weighted imaging and pathology of breast benign lesions

目的探讨乳腺良性病变MR平扫及扩散加权表现特征与病理结果的关系。方法 60例89个经手术病理证实的良性病变术前行MR检查,b值分别为0、1000s/mm2个,计算其表观扩散系数(ADC)值,比较平扫及扩散加权成像(DWI)的检出率,不同病理类型良性病变的形态、信号强度及ADC值。结果 89个良性病变中纤维腺瘤53个,导管内乳头状瘤7个,囊肿9个,腺病伴腺瘤15个,腺病5个;扩散加权成像检出率(86.5%)高于MR平扫(70.8%),差异有统计学意义(P=0.005);导管内乳头状瘤ADC值低于腺病伴纤维腺瘤及单纯纤维腺瘤ADC值,差异有统计学意义(P=0.000)。结论 DWI诊断价值高于MR平扫,导管内乳头状瘤ADC值与乳腺癌接近,囊肿ADC值变化较大。

Objective To investigate the relationship between MRI plain scan and diffuse-weighted imaging （DWI） features and the pathological features of breast bemgn lesions. Methods 89 benign nodules in 60 cases confirmed by operation and pathology were all examined before operation. All patients were scanned with b values （b= 1 00-0 s/mm2） in DWI,the ADC values were calculated. The detection rates were compared between the plain scan and DWI, the different pathological types of benign nodules morphology,the signal intensity and ADC value were also compared. Results Among the 89 benign nodules,the fibroadenoma was 53 in number,intraductalpapilloma 7,cyst 9, adenosis with adenoma 15,adenosis 5. The DWI detection rate （86.5%） was higher than that of MR plain scan （70.8 %）. The ADC values of the iatraductal papilIoma were lower than those of the adenosis with fibroadenoma and the pure fibroadenoma of breast. The difference was significant. Conclusion The diagnostic value of DWI is higher, than that of MR plain scan. No significant difference are seen in MRI shape and edge of the different pathologic types of benign nod- ules. ADC values of the intraduetal papilloma close to breast cancer. According to different pathological components, ADC values of the cysts varies greatly.