核磁共振ADC值对乳腺良恶性疾病的鉴别诊断价值

Value of nuclear magnetic resonance ADC in differential diagnosis of benign and malignant breast diseases

目的 探讨核磁共振表观扩散系数（ADC）值在乳腺良恶性疾病中的鉴别诊断价值.方法 回顾性分析2013年12月至2015年10月深圳市妇幼保健院甲乳科经手术病理证实的乳腺良恶性疾病患者42例,其中乳腺癌10例,乳腺囊肿12例,乳腺炎9例,乳腺纤维瘤11例,所有患者术前均行乳腺MRI、DWI检查,采用单次激发EPI序列,b值为0 s/mm2和800 s/mm2.于常规乳腺体检者中选取12例健康正常乳腺区域测量ADC值作为对照组,比较两组的ADC值差异.结果 乳腺癌、乳腺囊肿、乳腺炎、乳腺纤维瘤及正常乳腺区域的ADC值分别为（1.08±0.27）×10^-3 mm2/s、（2.02±0.10）×10^-3 mm2/s、（1.44±0.51）×10^-3 mm2/s、（1.68±0.48）×10^-3 mm 2/s、（2.15±0.21）×10^-3 mm2/s,各组差异有统计学意义（F=49.032,P=0.000）,组间两两比较,除乳腺炎和乳腺囊肿外,余各组间两两比较差异均有统计学意义（P〈0.05）.结论 ADC值测量能给临床提供乳腺良恶性疾病的鉴别诊断依据.

Objective To investigate the value of nuclear magnetic resonance apparent diffusion coefficient（ADC）in the differential diagnosis of benign and malignant breast diseases. Methods Forty-two patients diagnosed with benign and malignant breast diseases by surgical pathology in the Department of Thyroid and Galactophore,Shenzhen Municipal Maternal and Child Health Hospital between December 2013 and October 2015 were retrospectively analyzed,including 10 cases of breast cancer,12 of breast cyst,9 of mastitis,and 11 of breast fibroma. All patients underwent preoperative breast MRI and DWI examinations using single shot sequence of EPI sequence with b values of 0 s/mm2 and 800 s/mm2,respectively. In the subjects received routine breast examination,the ADC values of 12 healthy normal breast areas were included as the control group,and the difference in ADC value between the two groups was compared. Results The ADC values in the breast cancer, breast cyst,mastitis,breast fibroma and normal breast areas were（1.08±0.27）×10^-3 mm2/s,（2.02±0.10）×10^-3 mm^2/s,（1.44±0.51）×10^-3 mm2/s,（1.68±0.48）×10^-3 mm2/s,（2.15±0.21）×10^-3 mm2/s,respectively,and there was statistically significant difference in the groups（F=49.032,P=0.000）. Except for mastitis and breast cyst, there was statistically significant difference between the groups（P〈0.05）. Conclusion The measurement of ADC value can provide the basis for differential diagnosis of benign and malignant breast diseases.