1.5 T MRI不同b值DWI在乳腺疾病诊断中的应用价值

Application Value of DWI with Different b Values of 1.5 T MRI in the Diagnosis of Breast Diseases

【目的】探讨1.5 T磁共振成像(MRI)不同b值弥散加权成像(DWI)在乳腺疾病诊断中的应用价值。【方法】回顾性分析2018年2月至2020年2月西安市人民医院(西安第四医院)大差市院区行1.5 T MRI检查的84例女性乳腺疾病患者的临床资料,其中良性病变30例(良性组),恶性病变54例(恶性组)。观察常规MRI及DWI成像表现,分析两组不同b值下ADC值变化情况,判断不同b值下ADC值对乳腺良恶性病变的诊断效能。【结果】30例良性病变患者中,18例T_(2)WI压脂序列呈高信号,12例呈稍高信号;26例病灶边缘清晰,4个边缘不清;23例DWI上呈均匀稍高信号。54例恶性病变患者中,49例T_(2)WI压脂序列呈高信号,5例呈稍高信号;3例病灶边缘清晰,51例病灶边缘不清,周围可见毛刺或分叶状改变;5例DWI上呈均匀稍高信号,其余49例均呈明显高信号。当b值为1000 s/mm^(2)、1500 s/mm^(2)时,良性组ADC值均显著高于恶性组(P<0.05)。ROC曲线结果显示,不同b值(1000 s/mm^(2)、1500 s/mm^(2))下ADC值对乳腺良恶性病变均有一定诊断效能,曲线下面积分别为0.839、0.783。【结论】1.5 T MRI不同b值DWI对乳腺良恶性病变均有一定诊断效能,而b值为1000 s/mm^(2)时对乳腺良恶性病变的诊断效能最高。

【Objective】To explore the application value of diffusion weighted imaging(DWI)with different b values of 1.5 T magnetic imaging(MRI)in the diagnosis of breast diseases.【Methods】The clinical data of 84 female patients with breast diseases who underwent 1.5 T MRI from February 2018 to February 2020 in Dacha District of Xi'an People's Hospital(Xi'an Fourth Hospital)were retrospectively analyzed,including 30 cases of benign lesions(benign group)and 54 cases of malignant lesions(malignant group).The conventional MRI and DWI imaging manifestations were observed,and the changes of ADC values under different b values in the two groups were analyzed to judge the diagnostic efficacy of ADC values under different b values for benign and malignant breast lesions.【Results】Among the 30 patients with benign lesions,18 cases showed high signal intensity on T_(2)WI lipid compression sequence,and 12 cases showed slightly high signal intensity;In 26 cases,the edges of the lesions were clear,and 4 edges were unclear;23 cases showed uniform and slightly high signal on DWI.Among 54 patients with malignant lesions,49 cases showed high signal on T_(2)WI lipid compression sequence,and 5 cases showed slightly high signal;The edges of the lesions were clear in 3 cases,unclear in 51 cases,and burrs or lobulated changes were seen around them;5 cases showed uniform and slightly high signal on DWI,and the other 49 cases showed obvious high signal.When the b value was 1000 s/mm^(2) and 1500 s/mm^(2),the ADC value of benign group was significantly higher than that of malignant group(P<0.05).The results of ROC curve showed that ADC values under different b values(1000 s/mm^(2),1500 s/mm^(2))had certain diagnostic efficacy for benign and malignant breast lesions,and the areas under the curve were 0.839 and 0.783 respectively.【Conclusion】DWI with different b values of 1.5 T MRI has certain diagnostic efficiency for benign and malignant breast lesions,and the diagnostic efficiency for benign and malignant breast lesions is the highest when the b value is 1000 s/mm^(2).