MRI扩散加权成像(DWI)技术在乳腺良、恶性鉴别诊断中的价值研究

The Value of MRI Diffusion-weighted Imaging(DWI)in the Differential Diagnosis of Benign and Malignant Breast

目的分析MRI扩散加权成像(DWI)技术及表观扩散系数(ADC)值在乳腺良、恶性鉴别诊断中的价值。方法选定本院乳腺专科门诊2019年9月至2021年8月接诊的90例乳腺病变患者,分别给予超声、DWI检查,将病理活检穿刺作为本次研究的金标准,对比超声、DWI诊断准确率、特异度、灵敏度,Kappa检验超声、DWI与病理活检穿刺的一致性。对比良性乳腺病变、乳腺癌不同分级组ADC值。结果病理活检穿刺确诊23例乳腺癌、67例乳腺良性病变。超声确诊9例乳腺癌、81例乳腺良性病变。DWI确诊21例乳腺癌、69例乳腺良性病变。DWI诊断准确率(95.56%)、灵敏度(86.96%)、特异度(98.51%)均高于超声(66.67%、4.35%、88.06%),P<0.05(差异均具有统计学意义),Kappa检验超声病理活检穿刺的一致性一般(Kappa值=0.568),DWI与病理活检穿刺的一致性较好(Kappa值=0.764),P<0.05(差异均具有统计学意义)。乳腺癌Ⅲ级组ADC值低于Ⅱ级组、Ⅰ级组、良性乳腺病变组,P<0.05(差异均具有统计学意义)。结论DWI扫描在乳腺癌诊断中具有较高的准确率、灵敏度、特异度,通过测量ADC值,可对良、恶性病变作出准确的鉴别。

Objective To analyze the value of MRI diffusion-weighted imaging(DWI)technique and apparent diffusion coefficient(ADC)value in the differential diagnosis of benign and malignant breast.Methods A total of 90 patients with breast lesions who were admitted to the breast specialist clinic of our hospital from September 2019 to August 2021 were selected and given ultrasound and DWI examinations respectively.Pathological biopsy puncture was taken as the gold standard of this study,and ultrasound and DWI were compared.Diagnostic accuracy,specificity,sensitivity,Kappa test for the consistency of ultrasound,DWI and biopsy biopsy.The ADC values of benign breast lesions and different grades of breast cancer were compared.Results Pathological biopsy confirmed 23 cases of breast cancer and 67 cases of benign breast lesions.Ultrasound confirmed 9 cases of breast cancer and 81 cases of benign breast lesions.DWI confirmed 21 cases of breast cancer and 69 cases of benign breast lesions.The diagnostic accuracy(95.56%),sensitivity(86.96%)and specificity(98.51%)of DWI were higher than those of ultrasound(66.67%,4.35%,88.06%),P<0.05(the differences were all statistically significant),Kappa test The consistency of ultrasound pathological biopsy puncture was general(Kappa value=0.568),and the consistency of DWI and pathological biopsy puncture was good(Kappa value=0.764),P<0.05(both differences were statistically significant).The ADC value of breast cancer gradeⅢgroup was lower than that of gradeⅡgroup,gradeⅠgroup and benign breast lesion group,P<0.05(all differences were statistically significant).Conclusion DWI scanning has high accuracy,sensitivity and specificity in the diagnosis of breast cancer.By measuring the ADC value,benign and malignant lesions can be accurately distinguished.