3.0T MR动态增强及扩散加权成像诊断乳腺纤维腺病的价值研究

The diagnostic value of 3.0T dynamic enhanced MRI and DWI in breast fibroadenopathy

目的:分析乳腺纤维腺病MRI的形态学、动态增强(Dynamic contrast enhanced magnetic resonance imaging,DCEMRI)、扩散加权及表观扩散系数特征,探讨MRI诊断乳腺纤维腺病的价值。方法:回顾性分析我院2014年1月—2018年4月经手术病理证实为乳腺纤维腺病的20例患者,全部于术前1周内行3.0T MRI乳腺平扫及动态增强检查。依据美国放射学会提出的乳腺影像报告和数据系统磁共振成像(BI-RADS-MRI)标准,观察病灶形态、大小、边缘、内部强化、早期及晚期强化方式,测量早期强化率及ADC值,并与同层面正常乳腺组织对照。绘制受试者工作特征(ROC)曲线,比较早期强化率和ADC值诊断纤维腺病的价值。结果:20例乳腺纤维腺病中10例为肿块型,10例为非肿块型。纤维腺病的早期强化率和ADC值分别为(70.3±59.3)%、(1.25±0.33)×10^-3 mm^2/s,同层面正常乳腺组织分别为(18.2±18.6)%和(1.65±0.24)×10^-3 mm^2/s,二者差异有统计学意义。早期强化率和ADC值具备鉴别纤维腺病和正常乳腺组织的能力,二者联合诊断纤维腺病的ROC曲线下面积为0.905,敏感度为90.0%,特异度为80.0%,最大约登指数为0.7。结论:乳腺纤维腺病具有一定的MRI特征,早期强化率及ADC值具备一定的诊断价值。

Objective:To investigate the features of morphology,dynamic contrast enhanced magnetic resonance imaging(DCE-MRI),diffusion weighted imaging(DWI),and the apparent diffusion coefficient(ADC)value of breast fibroadenopathy and to explore the value of MRI diagnosis of breast fibroadenopathy.Methods:20 patients with breast fibroadenopathy confirmed by pathology in our hospital from January 2014 to April 2018 were retrospectively analyzed.All of the patients were examined by DWI and DCE-MRI within 1 week preoperatively.MRI features of lesions were analyzed according to the American College of Radiology Breast Imaging Reporting and Data System Magnetic Resonance Imaging(BI-RADS-MRI)standard,the lesion morphology,size,margin,internal enhancement,early and late enhancement methods were observed.The early enhancement ratio and ADC value of lesions were measured and compared with normal breast tissue at the same level.Receiver operating characteristic(ROC)curve analysis was performed for the comparison of the value of early enhancement rate and ADC value in the diagnosis of fibroadenopathy.Results:Among all the fibroadenopathy cases,10 were mass type and 10 were non-tumor type.The early enhancement ratio and ADC value of fibroadenopathy were(70.3±59.3)%and(1.25±0.33)×10^-3 mm^2/s,respectively,compared with(18.2±18.6)%and(1.65±0.24)×10^-3 mm^2/s of normal breast tissue,and significant differences were found(P<0.05).The early enhancement ratio and ADC value were effective for identifying breast fibroadenopathy from breast tissue.The area under the ROC curve for the combined diagnosis of breast fibroadenopathy was 0.905.The sensitivity was 90.0%,the specificity was 80.0%,and the maximum Youden index was 0.7.Conclusion:The characteristic of MRI findings can be found in breast fibroadenopathy.The early enhancement ratio and ADC value are helpful for the diagnosis of breast fibroadenopathy.