动态增强MRI联合DWI在乳腺良恶性疾病中的应用价值

Evaluation of diffusion weighted imaging and dynamic contrast-enhanced MR imaging in breast lesions

目的评价动态增强MRI联合DWI在乳腺良恶性病变中的应用价值。方法回顾性分析2018年9月-2019年3月河南省人民医院57例(62个病灶)乳腺病变患者的病例资料,分析乳腺病变的动态增强MR表现及时间-信号强度曲线类型;测量病变ADC值,对浸润性导管癌与导管原位癌的ADC值进行统计学分析.;统计动态增强MRI联合DWI评价乳腺良恶性病变的敏感度、特异度和准确度。结果①b值为800 s/mm2时乳腺良恶性病变的平均ADC值分别为(1.42±0.13) 10-3 mm2/s和(1.05±0.09) 10-3 mm2/s,有显著统计学差异(P<0.05),动态增强MRI和DWI联合诊断乳腺病变的敏感度94.1%,特异度92.2%,准确度93.2%。②浸润性导管癌与导管原位癌的平均ADC值为(0.92±0.13) 10-3 mm2/s和(1.19±0.07) 10-3 mm2/s,两者间差异有显著统计学意义(P<0.05)。结论 DWI有助于提高MR检查的特异度,联合应用动态增强MRI和DWI在乳腺良恶性病变的诊断及鉴别诊断中有临床应用价值。

Objective To evaluate the diffusion weighted imaging(DWI) and dynamic contrast-enhanced MR imaging in the diagnosis of breast diseases.Methods DCE-MRI and DWI were performed in 57 female patients(62 lesions),the pathology results were confirmed by surgery and biopsies.The ADC values of all breast lesions were calculated, The sensitivity, specificity and accuracy of diagnosing breast lesions by both DWI and DCE-MRI were also studied.Results ①b=800 s/mm2, the ADC values of benign and malignant lesions were(1.42±0.13) 10-3 mm2/s and(1.05±0.09) 10-3 mm2/s respectively(P<0.05), Combining the DCE-MRI and DWI, the united sensitivity, specificity and accuracy are 94.1%,92.2% and 93.2%. ②The ADC values of IDC and DCIS lesions were(0.92±0.13) 10-3 mm2/s and(1.19±0.07) 10-3 mm2/s respectively(P<0.05).Conclusion Combining DWI and DCE-MRI is helpful to differentiate breast malignant and benign lesions.