酰胺质子转移成像和扩散加权成像鉴别诊断乳腺良恶性病变

Amide proton transfer-weighted imaging and diffusion weighted imaging in differential diagnosis of benign and malignant breast lesions

目的观察MR酰胺质子转移成像(APTWI)和扩散加权成像(DWI)鉴别诊断乳腺良恶性病变的价值,并分析不同参数间的相关性。方法对65例乳腺病变患者行APTWI及DWI,测量并比较乳腺良恶性病变间平均ADC(ADCmean)、最小ADC(ADCmin)及非对称磁化转移率[MTRasym(3.5 ppm)]值的差异;采用ROC曲线评估各参数鉴别乳腺良恶性病变的诊断效能,并分析良恶性病变中各参数间的相关性。结果共70个病灶纳入研究,包括32个良性(良性组)和38个恶性病灶(恶性组)。良性组ADCmean、ADCmin及MTRasym(3.5 ppm)值均高于恶性组(t=-5.63、-5.94、-0.24,P均<0.05);ADCmin、ADCmean及MTRasym(3.5 ppm)鉴别乳腺良恶性病变的AUC分别为0.850、0.827及0.729(P均<0.01);ADCmin的AUC大于MTRasym(3.5 ppm)值(Z=1.990,P=0.046),其余各参数AUC差异均无统计学意义(P均>0.05)。恶性组MTRasym(3.5 ppm)值与ADC_(mean)(r=-0.325,P=0.046)和ADCmin值(r=-0.384,P=0.017)均呈负相关;良性组MTRasym(3.5 ppm)值与ADCmin值呈负相关(r=-0.357,P=0.045)。结论 APTWI及DWI均可用于鉴别诊断乳腺良恶性病变;相比DWI,APTWI的诊断效能有待进一步提高。

Objective To investigate the value of amide proton transfer-weighted imaging(APTWI)and diffusion weighted imaging(DWI)in differential diagnosis of benign and malignant breast lesions,and to analyze the correlations of different parameters.Methods APTWI and DWI were collected from 65 patients with breast lesions.The mean ADC value(ADC mean),the minimum ADC value(ADC min)and asymmetric magnetic transfer rate(MTRasym[3.5 ppm])were measured and compared between benign and malignant breast lesions.ROC curve was used to evaluate the diagnostic efficacy of each parameter for differentiating benign and malignant breast lesions,and the correlations of parameters in benign or malignant breast lesions were analyzed.Results Totally 70 breast lesions were brought into study,including 32 benign(benign group)and 38 malignant lesions(malignant group).ADC mean,ADC min and MTRasym(3.5 ppm)in benign group were all higher than those in malignant group(t=-5.63,-5.94,-0.24,all P<0.05).ROC curve analysis results showed that AUC of ADC min,ADC mean,and MTRasym(3.5 ppm)in differentiating benign and malignant breast lesions was 0.850,0.827,and 0.729,respectively(all P<0.01).AUC of ADC min was larger than that of MTRasym(3.5 ppm)values(Z=1.990,P=0.046),while AUC of other parameters were not significantly different(all P>0.05).In malignant group,MTRasym(3.5 ppm)value was negatively correlated with ADC mean(r=-0.325,P=0.046)or ADC min value(r=-0.384,P=0.017),while in benign group,MTRasym(3.5 ppm)value was negatively correlated with ADC min value(r=-0.357,P=0.045).Conclusion Both APTWI and DWI could be used for differentiating benign and malignant breast lesions.Compared with DWI,the diagnostic efficacy of APTWI should be further improved.