磁共振ADC值在乳腺良恶性病变鉴别诊断中的价值

The Value of Magnetic Resonance ADC Values in the Differential Diagnosis of Benign and Malignant Breast Lesions

目的评估磁共振表观弥散系数(apparent diffusion coefficient,ADC)值在鉴别乳腺良恶性病变中的作用,并确立最佳诊断阈值。方法回顾性分析菏泽市立医院自2018年1月—2022年3月期间行磁共振检查的乳腺良恶性病变102例,均经病理证实,均在常规序列基础上加扫描DWI序列,并自动重建ADC图。其中恶性组55例,良性组47例,每个病变均测量ADC值。分析两组间ADC值的差异,并做ROC曲线分析。结果恶性组ADC值均值为(0.99±0.25)×10^(−3)mm^(2)/s,良性组ADC值均值为(1.64±0.32)×10^(−3)mm^(2)/s,两组间差异有统计学意义(t=11.347,P<0.001)。ROC曲线分析显示将诊断阈值定为1.11×10^(−3)mm^(2)/s时,诊断的敏感性为90.9%,特异性为97.9%,诊断准确率为96.0%。结论磁共振ADC值在乳腺良恶性病变鉴别诊断中,敏感性和特异性高,具有较高的应用价值。

Objective To evaluate the role of MRI apparent diffusion coefficient(ADC)values in the differential diagnosis of benign and malignant breast lesions,and to establish the optimal diagnostic threshold.Methods Retrospective analysis of 102 cases of benign and malignant breast lesions in Heze Municipal Hospital who underwent MRI from January 2018 to March 2022,all confirmed by pathology,were scanned with DWI sequences on top of conventional sequences,and ADC maps were automatically reconstructed.Among them,55 cases were in the malignant group and 47 cases in the benign group,and ADC values were measured for each lesion.The differences in ADC values between the two groups were analyzed,and ROC curve analysis was done.Results The mean ADC value was(0.99±0.25)×10^(-3)mm^(2)/s in the malignant group and(1.64±0.32)×10^(-3)mm^(2)/s in the benign group,the difference was statistically significant between the two groups(t=11.347,P<0.001).The ROC curve analysis showed that the sensitivity of diagnosis was 90.9%,the specificity was 97.9%,and the diagnostic accuracy was 96.0%when the diagnostic threshold was set at 1.11×10^(-3)mm^(2)/s.Conclusion Magnetic resonance ADC values have high sensitivity and specificity in the differential diagnosis of benign and malignant breast lesions,and have high application value.