MR扩散加权成像ADC值对乳腺占位性病变的诊断价值

Diagnostic Value of ADC of MR Diffusion-Weighted Imaging in Breast Occupying Lesions

目的探讨MR扩散加权成像(DWI)表观扩散系数(ADC)值对乳腺占位性病变的诊断价值。方法回顾性分析126例135个乳腺占位性病变资料,所有病例均行乳腺常规MR扫描、DWI及手术病理确诊,测量病灶平均ADC值,采用SPSS 17.0软件包进行统计学分析。结果良、恶性病变的平均ADC值分别为(1.515±0.303)×10-3mm2/s、(1.065±0.146)×10-3mm2/s,差异有统计学意义(P=0.000)。导管内乳头状瘤、炎症的ADC值均低于纤维腺瘤与腺病,差异均有统计学意义(P均<0.05);导管内乳头状瘤与炎症、纤维腺瘤与腺病间ADC值差异无统计学意义(P均>0.05)。浸润性导管癌的ADC值低于导管内癌,差异有统计学意义(P=0.000)。高级别与低级别导管内癌的ADC值差异无统计学意义(P=0.492)。Ⅰ、Ⅱ、Ⅲ级浸润性导管癌间的ADC值均无显著差异(P>0.05)。结论 DWI ADC值分析有助于乳腺占位性病变的诊断及鉴别诊断。

Objective To evaluate the value of ADC(apparent diffusion coefficient)in MR-DWI in the diagnosis of breast occupying lesions.Methods A total of 135 breast occupying lesions proved by pathological results were analyzed.All cases received routine MR examination and DWI(b=0 and 800 s/mm^2).ADC values of the lesions were measured.All data used SPSS 17.0 package for statistical analysis.Results The mean ADC value of benign lesions was lower than that of malignant lesions with significant difference(P=0.000).The mean ADC values of intraductal papilloma and inflammation were both lower than those of fibroadenoma and adenosis(all P<0.05).There was no significant difference between the intraductal papilloma and inflammation,while between the fibroadenoma and adenosis(all P>0.05).The mean ADC value of invasive ductal carcinoma was lower than that of intraductal carcinoma with significant difference(P=0.000).There was no significant difference between the high-grade and low-grade intraductal carcinoma(P=0.492).There were no significant differences between the grade I,II and III invasive ductal carcinoma(P>0.05).Conclusion ADC analysis of MR-DWI is of great value in the diagnosis of breast space-occupying lesions.